|AIDS (London, England). 2022 Aug 24. doi: 10.1097/QAD.0000000000003373. pii: 00002030-990000000-00102|
|Recent abacavir use and incident cardiovascular disease in contemporary treated people living with HIV.|
|Jaschinski N1, Greenberg L2, Neesgaard B3, Miró JM4, Grabmeier-Pfistershammer K5, Wandeler G6, Smith C7, De Wit S8, Wit F9, Pelchen-Matthews A10, Mussini C11, Castagna A12, Pradier C13, Monforte A14, Vehreschild J15, Sönnerborg A16, Anne AV17, Carr A18, Bansi-Matharu L19, Lundgren J20, Garges H21, Rogatto F22, Zangerle R23, Günthard HF24, Rasmussen LD25, Nescoi C26, Van Der Valk M27, Menozzi M28, Muccini C29, Mocroft A30, Peters L31, Ryom L32|
OBJECTIVE: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people living with HIV (PLWH).
DESIGN: Multinational cohort collaboration.
METHODS: RESPOND participants were followed from latest of 01/01/2012 or cohort enrolment until the first of a CVD event (myocardial infarction [MI], stroke, invasive cardiovascular procedure [ICP]), last follow-up or 31/12/2019. Logistic regression examined 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 past six months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.
RESULTS: Of 29,340 individuals, 34% recently used ABC. Compared to 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 median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate [IR] 4.7/1000 persons-years of follow up [4.3-5.0]). The adjusted CVD IR ratio was higher for individuals with recent ABC use (1.40 [1.20-1.64]) compared to 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.
CONCLUSION: 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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Publikations ID: 36001525