Abstract
Background
HIV has been associated with QT prolongation and it is believed this is from drug interaction as well as HIV infection. In vitro studies have showed that protease inhibitors block potassium channel HERG, suggesting that these drugs can cause drug-induced QT prolongation. Few case-reports have showed that protease inhibitors can cause drug-induced bradycardia, but data is still limited.
Objective
To describe the correlation between HIV infection and the duration of QT interval and to evaluate the effects that protease inhibitors-containing antiretroviral regime have on the duration of QT interval and cardiac frequency.
Methods
A cross-sectional study was made. Participants were assigned to 3 groups: HIV positive with antiretroviral therapy which included protease inhibitors (HIV+ with treatment), treatment-naïve HIV positive and HIV negative. None of the participants had past medical history of cardiovascular disease or use of known QT prolonging medication. 12-lead ECG were made to all participants. QT interval and cardiac frequency were measured to be compared between the 3 groups and the results were analyzed by the statistical test ANOVA.
Results
A total of 213 participants were enrolled, 84 in the HIV+ with treatment, 45 in the HIV+ treatment-naïve, and 84 HIV-. 63% of the participants were males. The treatment-naïve HIV+ group only had 5 female participants. This study did not find a relation between HIV infection or protease inhibitor use and an increase in the duration of QT interval in males. For females, this study found an association between HIV infection and longer QT interval duration, as seen in the mean of each group: 442.8 ms for treatment-naïve HIV+ group, 422.42 ms for protease inhibitor HIV+ with treatment group and 420.34 ms HIV- group. It was found that the use of antiretroviral regime with protease inhibitor was associated with a decrease in cardiac frequency, as seen in each group's cardiac frequencies: HIV+ with treatment group: 63.34 bpm, treatment-naïve HIV positive: 79.77 bpm and control group: 69.3 bpm.
Conclusion
We did not find correlation between HIV infection, the use of protease inhibitor-containing antiretroviral regime and QT interval prolongation in males, as opposed to females, where it was shown that QT interval duration is longer in the HIV+ treatment-naïve group. It was also observed that the use of protease inhibitor-containing antiretroviral regime was associated with a decrease in cardiac frequency.
Funding Acknowledgement
Type of funding source: None
Neurocognitive Function and Neuroimaging Markers in Virologically Suppressed HIV-positive Patients Randomized to Ritonavir-boosted Protease Inhibitor Monotherapy or Standard Combination ART: A Cross-sectional Substudy From the PIVOT Trial