Prevalence and Correlates of Electrocardiographic Abnormalities in Adults with HIV: Insights from the REPRIEVE Trial
Abstract
Background People with HIV (PWH) are at increased risk for cardiovasvular disease (CVD) and sudden cardiac death. Prior work has suggested an association between HIV infection and ECG abnormalities. There are limited data on the burden of ECG abnormalities among PWH in a multi-racial, multi-ethnic globally representative population.
Methods ECG findings were grouped into clinically relevant categories, using sex-specific thresholds when indicated. We used Fisher’s exact tests to assess associations of demographic characteristics and ECG abnormalities. We used logistic regression to assess associations between demographic and HIV management measures, with adjustment.
Results We analyzed data for 7,720 PWH (99% of participants) (median age 50 years, 69% male). There were 3,346 (43%) Black or African American, 2,680 (35%) White, and 1,139 (15%) Asian participants. Most (97%) participants had viral load that was <400 copies/ml or < lower limits of quantification. Nearly half of participants had at least one ECG abnormality (44%). QTc prolongation was more common among males than females (9% vs. 6%, p=0.001), and nearly twice as common among Asian participants (12%) compared with other racial groups (7%) (p<0.0001). Participants with viral load >400 copies/ml had approximately twice the odds of prolonged QTc compared to those that were undetectable (adjusted OR 2.05, 95% CI 1.22 to 3.45).
Conclusions Prolonged QTc is common among male, Asian and REPRIEVE participants with higher viral load. These relationships warrant future investigation of linkages to ensuing CVD events among PWH.