Combined antiretroviral therapy with low- or normal-protein, high-calorie diets appears to induce significant deleterious electrocardiographic changes in a rodent model.
This study examined how combination antiretroviral therapy (cART) interacts with calorie-dense diets to affect heart function in a rat model. One hundred and twenty weanling Sprague Dawley rats were assigned to one of three diets (normal chow, calorie-dense low-protein, or calorie-dense normal-protein) for 15 weeks, then subdivided into four treatment groups for an additional 9 weeks: saline control, dolutegravir (DTG) plus tesamorelin, DTG alone, or a classical cART regimen. At week 24, electrocardiographic (ECG) recordings and myocardial tissue analysis were performed. The study found statistically significant differences across groups in multiple ECG parameters, including Q, R, S, and T wave amplitudes, PR interval, QRS duration, ST height, and corrected QT interval. Myocardial fibrosis was notably observed in animals receiving DTG alone or classical cART while on calorie-dense diets. The authors suggest these structural changes may disrupt electrical conduction and predispose to arrhythmias. Notably, tesamorelin appeared to attenuate these cardiac effects, leading the authors to implicate growth hormone pathway dysfunction in the pathology. Key limitations include the exclusive use of an animal model, meaning findings may not directly translate to humans.