Predictors of electrocardiographic QT interval prolongation in men with HIV
Open accessAbstract
Objective: HIV-infected (HIV+) individuals may be at increased risk for sudden arrhythmic cardiac death. Some studies have reported an association between HIV infection and prolongation of the electrocardiographic QT interval, a measure of ventricular repolarisation, which could potentiate ventricular arrhythmias. We aimed to assess whether HIV+ men have longer QT intervals than HIV-uninfected (HIV−) men and to determine factors associated with QT duration. Methods: We performed resting 12-lead ECGs in 774 HIV+ and 652 HIV− men in the Multicenter AIDS Cohort Study (MACS). We used multivariable linear and logistic regression analyses to assess associations between HIV serostatus and Framingham corrected QT interval (QTc), after accounting for potential confounders. We also determined associations among QTc interval and HIV-related factors in HIV+ men. In a subgroup of participants, levels of serum markers of inflammation were also assessed. Results: After adjusting for demographics and risk factors, QTc was 4.0 ms longer in HIV+ than HIV− men (p<0.001). Use of antiretroviral therapy (ART), specific ART drug class use and other HIV-specific risk factors were not associated with longer QTc. Among the subgroup with inflammatory biomarker measurements, higher interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and B-cell activating factor levels were independently associated with longer QTc and their inclusion partially attenuated the HIV effect. Conclusions: HIV+ men had longer QTc, which was associated with higher levels of systemic inflammatory factors. This longer QTc may contribute to the increased risk for sudden arrhythmic cardiac death in some HIV+ individuals.
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Increased IL-6 levels are associated with prolonged QTc in patients with inflammatory conditions such as rheumatoid arthritis and infections including HIV and SARS-CoV-2.
“Increased levels of IL-6 are associated with prolonged QTc in patients with inflammatory conditions such as rheumatoid arthritis and infections including HIV and SARS-CoV-2 (30–33).”
From Effect of Hypoglycemia on QT Interval in Individuals With and Without Type 2 Diabetes: A Randomized Crossover Trial (2025) · cites this paper as [31]
The Results (page not provided) report that higher IL-6 levels were associated with longer QTc in a cohort that included men with HIV. The Discussion links systemic inflammation more generally—not IL-6 specifically—to longer QTc in rheumatoid arthritis. The paper does not address SARS-CoV-2, so it does not support the full sentence. (LLM, conf=0.87)
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- Authors
- Wu, K. C., Zhang, L., Haberlen, S. A., Ashikaga, H., Brown, T. T., Budoff, M. J., D’Souza, G., Kingsley, L. A., Palella, F. J., Margolick, J. B., Martínez-Maza, O., Soliman, E. Z., & Post, W. S.
- Affiliations
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Johns Hopkins University (US)
- University of California, Los Angeles (US)
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- University of Pittsburgh (US)
- Northwestern University (US)
- Department of Obstetrics and Gynecology, Microbiology, Immunology & Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Wake Forest University Health Sciences (US)
- ORCID
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2018-10-26
- Volume
- 105
- Issue
- 7
- Pages
- 559-565
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- PMC
- PMC7366367
- OpenAlex
- W2898254669
- Cited by
- 40
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 11 · 2020: 4 · 2019: 5 · 2018: 1
- FWCI
- 6.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases
- National Heart, Lung, and Blood Institute
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- HIV infection, QT prolongation, ventricular repolarization, sudden cardiac death, antiretroviral therapy, systemic inflammation, interleukin-6, ICAM-1, B-cell activating factor, men, Multicenter AIDS Cohort Study
- MeSH terms
- Correlation of Data, Adult, Electrocardiography, Humans, Long QT Syndrome, Male, Middle Aged, Risk Factors, Serologic Tests, United States, Biomarkers, HIV Infections, Interleukin-6, Death, Sudden, Cardiac, Risk Assessment, Intercellular Adhesion Molecule-1, Anti-Retroviral Agents, B-Cell Activating Factor
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