The influence of antiretroviral therapy on QTc interval amongst HIV patients at Aga Khan University Hospital, Nairobi

Author

Jay Shavadia, Aga Khan University

Date of Award

7-27-2009

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Gerald Yonga

Second Supervisor/Advisor

Reena Harania

Department

Pathology (East Africa)

Abstract

Aim: To determine the influence of antiretroviral (ARV) therapy on the QT_C interval amongst HIV-infected patients.

Design: Prospective Comparative survey of two population samples

Patients and Setting: One hundred and thirty ARV naïve and one hundred and thirty treated HIV-positive patients selected from in and out patient departments of Aga Khan University Hospital underwent clinical evaluation and 12 lead resting ECG between August 2008 and March 2009.

Methodology: Eligible HIV-positive patients were conveniently sampled and had a 12-lead electrocardiogram (ECG) performed to determine the QTinterval, corrected for the heart rate by the Bazzet formula. Analysis was then performed to determine the odds of development of a prolonged QT_C interval (QT_C ≥ 440ms) in the ARV-experienced arm compared to the ARV-naïve arm.

Results: One hundred and thirty patients in each of the two study arms’ had ECG assessment of the QT_C interval. 16.2% of the patients in the ARV-experienced arm had QT_C prolongation compared to 6.9% in the ARV-naïve arm (chi square 5.43, p= 0.01) giving rise to an odds ratio of 2.5 (95% CI 1.01-6.67).

Conclusion: ARV use significantly increases the risk of development of an acquired long QT_C syndrome by two-and-a-half times.

Recommended Citation

Shavadia, J. (2009). The influence of antiretroviral therapy on QTc interval amongst HIV patients at Aga Khan University Hospital, Nairobi (Unpublished master's dissertation). Aga Khan University, East Africa.