Incidence and Predictors of QTC Prolongation Among Drug-Resistant Tuberculosis Patients Receiving Bedaquiline-Based TB Regimens in Uganda: A Countrywide Retrospective Cohort Study.

Authors

Marble Nasasira, Kevin Ouma Ojiambo, Daniel Iraguha, Joseph Baruch Baluku

Published in

Open forum infectious diseases. Volume 13. Issue 10. Pages ofag637. Epub Oct 05, 2026.

Abstract

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.
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.
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; P = .031) increased risk of QTc prolongation. Treatment success was similar among patients with and without QTc prolongation: 73.9% (51/69) vs 68.3% (316/463); P = .873.
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.

PMID:
42898576
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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