Role of antiretroviral treatment in prolonging QTc interval in HIV-positive patients

Pierangelo Chinello, Francesco P. Lisena, Claudio Angeletti, Evangelo Boumis, Federica Papetti, Nicola Petrosillo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The aims of our study were to assess the prevalence of QTc prolongation in a group of HIV-infected individuals and to evaluate the associated risk factors. Methods: All the 650 HIV-infected patients followed up at our outpatient clinic underwent ECG recording. A "nested" case-control study was performed using as cases 64 HIV-infected patients with QTc >0.44 s and as controls (1:4) 256 HIV-positive subjects matched by gender and age with QTc interval ≤0.44 s. Results: A prolonged QTc interval was found in 9.8% of HIV-positive individuals (64/650). In the nested case-control study, an increased risk of having a prolonged QTc interval was observed among patients taking nelfinavir, efavirenz, methadone, cotrimoxazole or an excessive amount of alcohol. When a zidovudine (AZT)-containing backbone was associated with nelfinavir-based or efavirenz-based antiretroviral therapy, the risk of having a prolonged QTc interval was about three times higher than in patients taking nelfinavir or efavirenz without AZT. Conclusions: Several drugs administered to HIV-infected patients may cause a QTc interval prolongation increasing the risk of serious arrhythmias. An ECG follow-up for the assessment of QTc seems to be advisable for HIV-infected patients receiving drugs with a QTc prolonging potential.

Original languageEnglish
Pages (from-to)597-602
Number of pages6
JournalJournal of Infection
Volume54
Issue number6
DOIs
Publication statusPublished - Jun 2007

Keywords

  • Efavirenz
  • HIV
  • Nelfinavir
  • QT interval
  • Zidovudine

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Microbiology
  • Parasitology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

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