ArticleOpen forum infectious diseases2026
Incidence and Predictors of QTC Prolongation Among Drug-Resistant Tuberculosis Patients Receiving Bedaquiline-Based TB Regimens in Uganda: A Countrywide Retrospective Cohort Study.
Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Bedaquiline improves culture conversion in drug-resistant tuberculosis (DR-TB) treatment; its main safety concern is QTc prolongation, particularly when combined with other anti-TB drugs. This study assessed the incidence and predictors of QTc prolongation among DR-TB patients receiving bedaquiline under programmatic conditions in Uganda. Methods: We conducted a retrospective cohort study using medical records from 14 DR-TB treatment sites across Uganda (January 2017-December 2022). Data on demographics, clinical characteristics, bedaquiline-based regimens, treatment duration, and QTc intervals were collected. Incidence rates with 95% CIs were calculated for QTc prolongation, while modified Poisson regression was used to identify predictors of QTc prolongation. Results: Data were abstracted from 532 patients, 70.9% of whom were male. The mean (SD) age was 41.4 (15.9) years, and 34.6% were coinfected with HIV. The baseline mean (SD) QTc was 426.8 (28.4) ms, with a median follow-up (interquartile range) of 10.3 (7.2-13.5) months. The overall incidence of QTc prolongation was 12.0 cases per 1000 person-months (95% CI, 10.8-16.8). Lower body mass index (BMI; incidence rate ratio [IRR], 0.924; 95% CI, 0.860; IRR, 0.993; Conclusions: An average of 12 new cases of QTc prolongation was observed for every 1000 person-months of accumulated observation time. The recommended monthly electrocardiogram monitoring should be emphasized among patients with low baseline BMI. QTc prolongation was not linked to poor treatment outcomes.
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