Prevalence of prolonged QTc interval among HIV infected patients on highly active antiretroviral therapy (HAART) and its relationship with cd4 cells count and viral load at a tertiary hospital in North Eastern Nigeria.

Abstract

Background: Patients living with HIV infection remain at increased risk of cardiovascular diseases and sudden cardiac death.
Various prevalences of electrocardiographic (ECG) abnormalities among HIV-infected patients were reported: Attamah et al
reported the prevalence of electrocardiographic abnormalities among HIV-infected patients as 34.5%, while Orunta et al
reported a prevalence of 42.9%, and Njoku et al reported a prevalence of 93.0%. Human immunodeficiency virus-infected
patients are at increased risk of developing prolonged QT interval. Sani et al reported the prevalence of prolonged corrected
QT interval among HIV-infected patients was 45.0%. Innocent et al reported a prevalence of 48.0%, while Ajala et al reported a
prevalence of 18%. Prolonged QTc interval increases the risk of premature ventricular contraction which can degenerate into
ventricular tachycardia and or ventricular that can result in sudden cardiac death.
Methodology: The study was a cross-sectional conducted among HIV-infected patients receiving HAART at the Federal
Medical Centre Nguru, Yobe State, North Eastern Nigeria.
Results: One hundred and seven (107) subjects were recruited into the study comprising thirty-three (37.0%) males and
70(65.4%) females. The mean CD4 cell count and viral load of the studied patients were 612.64±34.75 cells/μL
and4646.30±58.68 copies/mL respectively. Twenty (18.7%) patients had prolonged QTc interval, this gave us the prevalence
of prolonged QTc in this study as 18.7%. The commonest cardiac rhythm was sinus rhythm (69.2%), followed by sinus
tachycardia (26.2%) and atrial fibrillation 5(4.7%). Other electrocardiographic findings include First-degree atrioventricular
block was seen in seven (6.5%) patients, Premature ventricular contractions were found in16.8%, RBBB was observed in
2.8%, 3.7% of patients had LBBB and 4.7% had left posterior hemiblock. The distribution of QTc interval according to CD4
cells count and viral revealed a statistically significant difference across the groups. All the patients with prolonged QTc
interval had lower CD4 cells count and higher viral load suggesting that HIV disease severity is associated with prolonged
QTc interval.
Conclusion: In conclusion, the study revealed that the prevalence of prolonged QTc interval among HIV-infected patients on
highly active antiretroviral therapy was found to be 18.7%, and that HIV disease severity increases the risk of developing
prolonged QTc interval.