Year : 2014  |  Volume : 16  |  Issue : 2  |  Page : 61-65

The QT interval in human immunodeficiency virus-positive Nigerian children

Department of Paediatrics, University of Jos, Jos, Nigeria

Correspondence Address:
Dr. Fidelia Bode-Thomas
Department of Paediatrics, Jos University Teaching Hospital, PMB 2076, Jos
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2276-7096.139049

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Introduction: The human immunodeficiency virus (HIV) and drugs taken for this infection are known to cause QTc interval prolongation which in turn can lead to severe arrhythmias. The prevalence and associated factors of prolonged QTc in HIV-positive children in sub- Saharan Africa have not been described. Objectives: To compare the mean QTc interval and prevalence of QTc prolongation in HIV-positive children and HIV-negative controls, and to determine the factors associated with prolonged QTc in HIV-positive children. Methodology: In a cross-sectional comparative study, the corrected QT intervals (QTc) of 100 HIV-positive children were compared with those of age- and sex-matched HIV-negative healthy controls. QTc > 0.46 seconds was regarded as prolonged. Results: Subjects were aged 9 months to 14 years. Mean QTc was significantly longer-43.31 (95% CI 43.30, 43.32) seconds in HIV-positive children (62% of whom were on anti-retroviral therapy) compared with controls-41.43 (41.42, 41.44) seconds (P < 0.0001). Mean QTc was also significantly longer in subjects receiving zidovudine (ZDV) - [0.46 (0.45, 0.47) versus 0.43 (0.42, 0.44) seconds] - P = 0.007 and efavirnez (EFV) - [0.45 (0.43, 0.47) versus 0.43 (0.42, 0.44) seconds] - P = 0.047 in subjects not on these drugs. Prolonged QTc was significantly more frequent in HIV-positive children (18.0%) compared with controls (0%) - P = 0.0001. There was no significant relationship between either the mean QTc or the frequency of prolonged QTc, and the subjects' mean age, sex, clinical or immunological stage of disease. Conclusion: Mean QTc is significantly longer in HIV-positive children (especially those receiving ZDV or EFV), compared with controls. Prolonged QTc is also significantly more frequent in subjects. Baseline and periodic ECG screening of HIV-positive children may facilitate early detection of QTc prolongation and help prevent fatal arrhythmias.

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