Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV
Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV. Multinational cohort collaboration. RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until th...
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| Veröffentlicht in: | AIDS (London) Jg. 37; H. 3; S. 467 |
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01.03.2023
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| Abstract | Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.
Multinational cohort collaboration.
RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the odds of starting ABC by 5-year CVD or chronic kidney disease (CKD) D:A:D risk score. We assessed associations between recent ABC use (use within the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.
Of 29 340 individuals, 34% recently used ABC. Compared with those at low estimated CVD and CKD risks, the odds of starting ABC were significantly higher among individuals at high CKD risk [odds ratio 1.12 (95% confidence interval = 1.04-1.21)] and significantly lower for individuals at moderate, high or very high CVD risk [0.80 (0.72-0.88), 0.75 (0.64-0.87), 0.71 (0.56-0.90), respectively]. During 6.2 years of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with individuals without, consistent across sensitivity analyses. The association did not differ according to estimated CVD (interaction P = 0.56) or CKD ( P = 0.98) risk strata.
Within RESPOND's contemporarily treated population, a significant association between CVD incidence and recent ABC use was confirmed and not explained by preferential ABC use in individuals at increased CVD or CKD risk. |
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| AbstractList | Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.OBJECTIVEAssessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.Multinational cohort collaboration.DESIGNMultinational cohort collaboration.RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the odds of starting ABC by 5-year CVD or chronic kidney disease (CKD) D:A:D risk score. We assessed associations between recent ABC use (use within the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.METHODSRESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the odds of starting ABC by 5-year CVD or chronic kidney disease (CKD) D:A:D risk score. We assessed associations between recent ABC use (use within the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.Of 29 340 individuals, 34% recently used ABC. Compared with those at low estimated CVD and CKD risks, the odds of starting ABC were significantly higher among individuals at high CKD risk [odds ratio 1.12 (95% confidence interval = 1.04-1.21)] and significantly lower for individuals at moderate, high or very high CVD risk [0.80 (0.72-0.88), 0.75 (0.64-0.87), 0.71 (0.56-0.90), respectively]. During 6.2 years of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with individuals without, consistent across sensitivity analyses. The association did not differ according to estimated CVD (interaction P = 0.56) or CKD ( P = 0.98) risk strata.RESULTSOf 29 340 individuals, 34% recently used ABC. Compared with those at low estimated CVD and CKD risks, the odds of starting ABC were significantly higher among individuals at high CKD risk [odds ratio 1.12 (95% confidence interval = 1.04-1.21)] and significantly lower for individuals at moderate, high or very high CVD risk [0.80 (0.72-0.88), 0.75 (0.64-0.87), 0.71 (0.56-0.90), respectively]. During 6.2 years of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with individuals without, consistent across sensitivity analyses. The association did not differ according to estimated CVD (interaction P = 0.56) or CKD ( P = 0.98) risk strata.Within RESPOND's contemporarily treated population, a significant association between CVD incidence and recent ABC use was confirmed and not explained by preferential ABC use in individuals at increased CVD or CKD risk.CONCLUSIONWithin RESPOND's contemporarily treated population, a significant association between CVD incidence and recent ABC use was confirmed and not explained by preferential ABC use in individuals at increased CVD or CKD risk. Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV. Multinational cohort collaboration. RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the odds of starting ABC by 5-year CVD or chronic kidney disease (CKD) D:A:D risk score. We assessed associations between recent ABC use (use within the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders. Of 29 340 individuals, 34% recently used ABC. Compared with those at low estimated CVD and CKD risks, the odds of starting ABC were significantly higher among individuals at high CKD risk [odds ratio 1.12 (95% confidence interval = 1.04-1.21)] and significantly lower for individuals at moderate, high or very high CVD risk [0.80 (0.72-0.88), 0.75 (0.64-0.87), 0.71 (0.56-0.90), respectively]. During 6.2 years of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with individuals without, consistent across sensitivity analyses. The association did not differ according to estimated CVD (interaction P = 0.56) or CKD ( P = 0.98) risk strata. Within RESPOND's contemporarily treated population, a significant association between CVD incidence and recent ABC use was confirmed and not explained by preferential ABC use in individuals at increased CVD or CKD risk. |
| Author | Rasmussen, Line D Günthard, Huldrych F Nescoi, Coca Carr, Andrew Greenberg, Lauren Wandeler, Gilles De Wit, Stéphane Castagna, Antonella Pradier, Christian Vehreschild, Jörg Ryom, Lene Anne, Alain V Menozzi, Marianna Sönnerborg, Anders Bansi-Matharu, Loveleen d'Arminio Monforte, Antonella Garges, Harmony Rogatto, Felipe Mocroft, Amanda Peters, Lars Wit, Ferdinand Neesgaard, Bastian Miró, Jose M Lundgren, Jens Muccini, Camilla Grabmeier-Pfistershammer, Katharina Smith, Colette Pelchen-Matthews, Annegret Zangerle, Robert Van Der Valk, Marc Jaschinski, Nadine Mussini, Cristina |
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Medizinische Universität Vienna, Vienna, Austria – sequence: 6 givenname: Gilles surname: Wandeler fullname: Wandeler, Gilles organization: Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland – sequence: 7 givenname: Colette surname: Smith fullname: Smith, Colette organization: The Royal Free HIV Cohort Study, Royal Free Hospital, University College London, London, UK – sequence: 8 givenname: Stéphane surname: De Wit fullname: De Wit, Stéphane organization: CHU Saint-Pierre, Centre de Recherche en Maladies Infectieuses a.s.b.l., Brussels, Belgium – sequence: 9 givenname: Ferdinand surname: Wit fullname: Wit, Ferdinand organization: AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, Stichting HIV Monitoring, Amsterdam, the Netherlands – sequence: 10 givenname: Annegret surname: Pelchen-Matthews fullname: Pelchen-Matthews, Annegret organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute 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surname: Sönnerborg fullname: Sönnerborg, Anders organization: Swedish InfCare HIV Cohort, Karolinska University Hospital, Stockholm, Sweden – sequence: 17 givenname: Alain V surname: Anne fullname: Anne, Alain V organization: European AIDS Treatment Group (EATG), Brussels, Belgium – sequence: 18 givenname: Andrew surname: Carr fullname: Carr, Andrew organization: HIV and Immunology Unit, St Vincent's Hospital, Sydney, NSW, Australia – sequence: 19 givenname: Loveleen surname: Bansi-Matharu fullname: Bansi-Matharu, Loveleen organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK – sequence: 20 givenname: Jens surname: Lundgren fullname: Lundgren, Jens organization: CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark – sequence: 21 givenname: Harmony surname: Garges fullname: Garges, Harmony organization: ViiV Healthcare, Research Triangle Park, NC – sequence: 22 givenname: Felipe surname: Rogatto fullname: Rogatto, Felipe organization: Gilead Sciences, Foster City, CA, USA – sequence: 23 givenname: Robert surname: Zangerle fullname: Zangerle, Robert organization: Austrian HIV Cohort Study (AHIVCOS), Medizinische Universität Innsbruck, Innsbruck, Austria – sequence: 24 givenname: Huldrych F surname: Günthard fullname: Günthard, Huldrych F organization: Institute of Medical Virology, University of Zurich, Zurich, Switzerland – sequence: 25 givenname: Line D surname: Rasmussen fullname: Rasmussen, Line D organization: Department of Infectious Diseases, Odense University Hospital, Odense – sequence: 26 givenname: Coca surname: Nescoi fullname: Nescoi, Coca organization: CHU Saint-Pierre, Centre de Recherche en Maladies Infectieuses a.s.b.l., Brussels, Belgium – sequence: 27 givenname: Marc surname: Van Der Valk fullname: Van Der Valk, Marc organization: AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, Stichting HIV Monitoring, Amsterdam, the Netherlands – sequence: 28 givenname: Marianna surname: Menozzi fullname: Menozzi, Marianna organization: Modena HIV Cohort, Università degli Studi di Modena, Modena – sequence: 29 givenname: Camilla surname: Muccini fullname: Muccini, Camilla organization: Nice HIV Cohort, Université Côte d'Azur et Centre Hospitalier Universitaire, Nice, France – sequence: 30 givenname: Amanda surname: Mocroft fullname: Mocroft, Amanda organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK – sequence: 31 givenname: Lars surname: Peters fullname: Peters, Lars organization: CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark – sequence: 32 givenname: Lene surname: Ryom fullname: Ryom, Lene organization: Department of Infectious Diseases 144, Hvidovre University Hospital, Copenhagen, Denmark |
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| SubjectTerms | Cardiovascular Diseases - chemically induced Cardiovascular Diseases - epidemiology Disease Progression HIV Infections - complications HIV Infections - drug therapy HIV Infections - epidemiology Humans Renal Insufficiency, Chronic - complications Risk Factors |
| Title | Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV |
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