Testosterone use and shorter electrocardiographic QT interval duration in men living with and without HIV

Abstract

Objectives Testosterone usage (T‐use) may alter risk factors for sudden cardiac death in men living with HIV (MLWH). Electrocardiographic QT interval prolongation, which could potentiate ventricular arrhythmias, has previously been associated with HIV infection and, separately, with low testosterone levels. We investigated whether T‐use shortens the QT interval duration in MLWH and HIV‐uninfected men. Methods We utilized data from the Multicenter AIDS Cohort Study, a prospective, longitudinal study of HIV infection among men who have sex with men. Multivariable linear regression analyses were used to evaluate associations between T‐use and corrected QT interval (QTc) duration. Results Testosterone usage was more common in MLWH compared with HIV‐uninfected men (19% vs. 9%). In a multivariable regression analysis, T‐use was associated with a 5.7 ms shorter QT interval [95% confidence interval (CI): −9.5 to −1.9; P = 0.003). Furthermore, stronger associations were observed for prolonged duration of T‐use and recent timing of T‐use. Conclusions This study is the first known analysis of T‐use and QTc interval in MLWH. Overall, our data demonstrate that recent T‐use is associated with a shorter QTc interval. Increased T‐use duration above a threshold of ≥ 50% of visits in the preceding 5 years was associated with a shorter QTc interval while lesser T‐use duration was not.

The impact of testosterone on the QT interval: A Systematic review

“…In men, testosterone ranges from 9-38 nmol/L and has QT shortening effects in a dose dependent manner, which become evident as testosterone rises with puberty (1). In different patient populations high testosterone levels (exogenous and endogenous) resulted in significant QT interval shortening in both men and women (8)(9)(10). For instance,Schwartz et al (8), showed that older men and women exposed to testosterone for 12 weeks presented with significant QT interval shortening (for men: 385 ± 28ms to 382 ± 28ms, p < 0.002; and for women: 400 ± 25ms to 397 ± 23ms, p = 0.06), when compared to placebo.…”