Characteristics and abnormal rate of electrocardiogram in patients with human immunodeficiency virus/acquired immunodeficiency syndrome / 中华传染病杂志

ABSTRACT

Objective To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS),and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.Methods The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved.The abnormality rates and characteristics of ECG were compared between the two groups.CD4 + T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/ AIDS patients.The comparison between two groups was conducted by chi-square test.Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.Results There were 611 cases (54.02％) out of 1 131 HIV/AIDS patients with abnormal ECG.The common abnormal ECG types were sinus tachycardia 239 cases (39.12％),sinus rhythm with ST-T changes 115 cases (18.82％) and sinus bradycardia 55 cases (9.00％).There were 1 958 cases (34.83％) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG.The common ECG abnormality types were sinus bradycardia 633 cases (32.33％),sinus rhythm with ST-T changes 463 cases (23.65％) and sinus arrhythmia 256 cases (13.07％).The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/ AIDS subjects (x2 =140.39,P ＜ 0.01).The abnormal rates of ECG in HIV/AIDS patients ＜ 50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group,and the differences were statistically significant (x2 =111.92 and 52.12,respectively,both P ＜ 0.01).Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with nonHIV/AIDS individuals (odds ratio (OR) =2.27,95％ confidence interval (CI) 2.00-2.60,P ＜ 0.01).The risk of ECG abnormality increased in patients aged ≥ 50 years (OR =1.60,95％ CI 1.45-1.77,P ＜ 0.01).The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts,CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (x2 =12.92,10.99 and 16.48,respectively,all P ＜0.05).The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR =1.50,95％ CI 1.15-1.96,P ＜ 0.01).When C D8+ T lymphocyte counts ≥ 500/pL,the risk of ECG abnormalities reduced (OR =0.75,95％ CI 0.58-0.96,P ＜ 0.01).Conclusions The abnormal rate of ECG in patients with HIV/AIDS is high.The sinus tachycardia and sinus rhythm with ST-T segment changes are common.The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥ 500/μL.Type distribution of ECG abnormalities is associated with cellular immune status of patients.