HIV infection and electrocardiogram abnormalities: baseline assessment from the CHART cohort

Y Ding; B Zhu; H Lin; X Chen; W Shen; X Xu; R Shi; X Xu; G Zhao; N He

doi:10.1016/j.cmi.2020.03.005

HIV infection and electrocardiogram abnormalities: baseline assessment from the CHART cohort

Clin Microbiol Infect. 2020 Dec;26(12):1689.e1-1689.e7. doi: 10.1016/j.cmi.2020.03.005. Epub 2020 Mar 17.

Authors

Y Ding¹, B Zhu¹, H Lin², X Chen², W Shen², X Xu¹, R Shi¹, X Xu¹, G Zhao³, N He⁴

Affiliations

¹ Department of Epidemiology, School of Public Health, Fudan University, the Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China.
² Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China.
³ Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
⁴ Department of Epidemiology, School of Public Health, Fudan University, the Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, Shanghai, China. Electronic address: nhe@shmu.edu.cn.

PMID: 32194160
DOI: 10.1016/j.cmi.2020.03.005

Abstract

Objectives: To investigate the prevalence of various electrocardiogram (ECG) abnormalities among HIV-positive and HIV-negative individuals.

Methods: This cross-sectional evaluation included 1412 HIV-positive and 2824 HIV-negative participants aged 18 to 75 years and frequency matched by age and sex, derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China, between February and December 2017.

Results: HIV-positive individuals had higher prevalence of sinus tachycardia (5.6% (79/1412) vs. 1.3% (36/2824), p < 0.001) and ST/T wave abnormalities (14.9% (211/1412) vs. 9.4% (264/1412), p < 0.001) but lower prevalence of sinus bradycardia (4.8% (68/1412) vs. 7.5% (211/2824), p 0.001); such associations remained statistically significant after adjusting for traditional risk factors (respectively, adjusted odds ratio (aOR) 4.68, 95% confidence interval (CI) 3.06-7.17; aOR 1.89, 95% CI 1.54-2.34; aOR 0.60, 95% CI 0.44-0.80). In adjusted models, being in higher carotid intima-media thickness categories was significantly associated with ST/T abnormalities in HIV-positive individuals only (0.78-1.00 mm: aOR 1.46, 95% CI 1.01-2.12; >1.00 mm: aOR 2.18, 95% CI 1.39-3.42), whereas being in higher blood pressure categories was significantly associated with both sinus tachycardia (prehypertension: aOR 5.61, 95% CI 1.76-17.91; hypertension: aOR 12.62, 95% CI 3.60-44.27) and ST/T abnormalities (hypertension: aOR 2.04, 95% CI 1.41-2.95) in HIV-negative individuals only. Longer duration of known HIV infection was the only HIV-specific factor of ST/T abnormalities (aOR 1.61, 95% CI 1.17-2.22), with none for sinus tachycardia.

Conclusions: HIV infection is independently associated with sinus tachycardia and ST/T abnormalities. Further research is needed to investigate specific mechanisms by which HIV infection leads to ECG abnormalities and to evaluate whether inclusion of ECG parameters improves cardiovascular disease prediction. Integrating ECG screening into routine HIV care is recommended in China.

Keywords: China; Electrocardiography; HIV; ST/T abnormalities; Sinus tachycardia.

MeSH terms

Adolescent
Adult
Aged
Arrhythmias, Cardiac* / complications
Arrhythmias, Cardiac* / diagnosis
Arrhythmias, Cardiac* / epidemiology
Blood Pressure
Carotid Intima-Media Thickness
China / epidemiology
Cross-Sectional Studies
Electrocardiography / statistics & numerical data*
Female
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
Male
Middle Aged
Young Adult