No abstract

Background: QT prolongation can predispose to torsade de pointes, which occurs at higher rates in people living with HIV (PLWH). Increased prevalence of prolonged corrected QT interval (QTc) has been reported in PLWH, suggesting that it may play a role in the increased risk for sudden cardiac death in this patient population. However, gaps in research due to limited participation of gender, racial and ethnic minorities continue to limit the interpretation of these findings. Our study assessed the hypothesis that Black and Latinx cis and transgender women living with HIV (WLWH) would have greater odds of having prolonged QTc. Methods: A cross-sectional study was conducted by retrospectively reviewing electronic medical records to investigate the duration of the QTc interval between 2 groups, 137 WLWH versus 135 women who are not living with HIV. Associations between long QTc interval and ethnicity, smoking, alcohol use, BMI, medications (methadone, antibiotics, antiretroviral therapy, and psychiatric drugs), CD4 count, hepatitis C, and heart failure were also assessed. QTc >460 milliseconds was considered prolonged. Results: In the univariate logistic regression, living with HIV had significantly higher odds of having prolonged QTc than the control group (odds ratio [OR] 1.842, 95% confidence interval [CI] 1.062-3.195, p=0.0298). After adjusting for the covariates selected a priori, living with HIV was associated with even higher odds of having prolonged QTc (OR 2.128, 95% CI 1.115-4.061, p=0.023). Having heart failure was also independently associated with higher odds of having prolonged QTc (OR 3.883, 95% CI 1.672-9.018, p=0.0016) even after adjusting for other covariates (OR 2.973, 95% CI 1.605-9.836, p=0.0029). Ethnicity, smoking, alcohol use, BMI, medications, CD4 count, and hepatitis C were not significantly associated with higher odds of having prolonged QTc. Conclusions: This study showed that in cis and transgender women of color, living with HIV and heart failure were both associated with higher odds of having prolonged QTc. In this patient population, implementing routine EKG screening should be considered by clinicians as a strategy, among others, to prevent cardiac rhythm disturbances and cardiovascular morbidity and mortality.