Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV
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Objective:Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.Design:Multinational cohort collaboration.Methods: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.Results: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.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.
Original language | English |
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Journal | AIDS |
Volume | 37 |
Issue number | 3 |
Pages (from-to) | 467-475 |
Number of pages | 9 |
ISSN | 0269-9370 |
DOIs | |
Publication status | Published - 2023 |
Bibliographical note
Funding Information:
RESPOND has received funding from ViiV Healthcare LLC, Gilead Sciences and Merck Sharp & Dohme. Additional support has been provided by participating cohorts contributing data in-kind and/or statistical support: Austrian HIV Cohort Study (AHIVCOS), The Australian HIV Observational Database (AHOD), CHU Saint-Pierre, University Hospital Cologne, EuroSIDA, Frankfurt HIV Cohort Study, Georgian National AIDS Health Information System (AIDS HIS), Modena HIV Cohort, San Raffaele Scientific Institute, Swiss HIV Cohort Study (SHCS), AIDS Therapy Evaluation in the Netherlands Cohort (ATHENA), Royal Free HIV Cohort Study. AHOD is further supported by grant No. U01-AI069907 from the US National Institutes of Health, and GNT1050874 of the National Health and Medical Research Council, Australia.
Publisher Copyright:
© Copyright 2023 Wolters Kluwer Health, Inc. All rights reserved.
- abacavir, antiretroviral drugs, antiretroviral therapy, cardiovascular disease
Research areas
ID: 369356204