OBJECTIVE: Recent results from the D:A:D Study indicated that the incidence of myocardial infarction (MI) increased by 26% per year of exposure to combination antiretroviral treatment (CART). The present study was performed to investigate whether this risk was similar when including other cardio- and cerebro-vascular disease events (CCVE). DESIGN: D:A:D is an international collaboration of 11 cohorts, following 23 468 HIV-infected patients prospectively at 188 clinics in 21 countries situated in Europe, USA and Australia. METHODS: The end-point was the occurrence of a first CCVE during prospective follow-up, defined as the first of: acute MI, invasive cardiovascular procedures, stroke, or death from other cardiovascular disease. Relative rates (RR) for CCVE from Poisson regression models and 95% confidence intervals (CI) are reported. All models are adjusted for other risk factors for CCVE, including age, gender, ethnicity, family history, body mass index, and smoking status as well as cohort and HIV transmission group. RESULTS: Over 36 145 person-years of follow-up, 207 patients experienced at least one CCVE (23.7% fatal). The first event was MI in 126 patients, invasive cardiovascular procedure in 39 patients, stroke in 38 patients, and death from other cardiovascular disease in four patients. The incidence of first CCVE was 5.7 per 1000 person-years [95% confidence interval (CI) 5.0-6.5] and increased with longer exposure to CART (RR per year of exposure, 1.26; 95% CI, 1.14-1.38; P < 0.0001). CONCLUSION: CART increases the risk of CCVD, and this increase is comparable with how CART affects the risk of MI. This finding is consistent with the hypothesis that atherosclerosis is a side-effect of CART.
OBJECTIVE: Recent results from the D:A:D Study indicated that the incidence of myocardial infarction (MI) increased by 26% per year of exposure to combination antiretroviral treatment (CART). The present study was performed to investigate whether this risk was similar when including other cardio- and cerebro-vascular disease events (CCVE). DESIGN: D:A:D is an international collaboration of 11 cohorts, following 23 468 HIV-infectedpatients prospectively at 188 clinics in 21 countries situated in Europe, USA and Australia. METHODS: The end-point was the occurrence of a first CCVE during prospective follow-up, defined as the first of: acute MI, invasive cardiovascular procedures, stroke, or death from other cardiovascular disease. Relative rates (RR) for CCVE from Poisson regression models and 95% confidence intervals (CI) are reported. All models are adjusted for other risk factors for CCVE, including age, gender, ethnicity, family history, body mass index, and smoking status as well as cohort and HIV transmission group. RESULTS: Over 36 145 person-years of follow-up, 207 patients experienced at least one CCVE (23.7% fatal). The first event was MI in 126 patients, invasive cardiovascular procedure in 39 patients, stroke in 38 patients, and death from other cardiovascular disease in four patients. The incidence of first CCVE was 5.7 per 1000 person-years [95% confidence interval (CI) 5.0-6.5] and increased with longer exposure to CART (RR per year of exposure, 1.26; 95% CI, 1.14-1.38; P < 0.0001). CONCLUSION: CART increases the risk of CCVD, and this increase is comparable with how CART affects the risk of MI. This finding is consistent with the hypothesis that atherosclerosis is a side-effect of CART.
Authors: Kathleen Falster; Jun Yong Choi; Basil Donovan; Chris Duncombe; Brian Mulhall; David Sowden; Jialun Zhou; Matthew G Law Journal: AIDS Date: 2009-11-13 Impact factor: 4.177
Authors: Margalida Rotger; Tracy R Glass; Thomas Junier; Jens Lundgren; James D Neaton; Estella S Poloni; Angélique B van 't Wout; Rubin Lubomirov; Sara Colombo; Raquel Martinez; Andri Rauch; Huldrych F Günthard; Jacqueline Neuhaus; Deborah Wentworth; Danielle van Manen; Luuk A Gras; Hanneke Schuitemaker; Laura Albini; Carlo Torti; Lisa P Jacobson; Xiuhong Li; Lawrence A Kingsley; Federica Carli; Giovanni Guaraldi; Emily S Ford; Irini Sereti; Colleen Hadigan; Esteban Martinez; Mireia Arnedo; Lander Egaña-Gorroño; Jose M Gatell; Matthew Law; Courtney Bendall; Kathy Petoumenos; Jürgen Rockstroh; Jan-Christian Wasmuth; Kabeya Kabamba; Marc Delforge; Stephane De Wit; Florian Berger; Stefan Mauss; Mariana de Paz Sierra; Marcelo Losso; Waldo H Belloso; Maria Leyes; Antoni Campins; Annalisa Mondi; Andrea De Luca; Ignacio Bernardino; Mónica Barriuso-Iglesias; Ana Torrecilla-Rodriguez; Juan Gonzalez-Garcia; José R Arribas; Iuri Fanti; Silvia Gel; Jordi Puig; Eugenia Negredo; Mar Gutierrez; Pere Domingo; Julia Fischer; Gerd Fätkenheuer; Carlos Alonso-Villaverde; Alan Macken; James Woo; Tara McGinty; Patrick Mallon; Alexandra Mangili; Sally Skinner; Christine A Wanke; Peter Reiss; Rainer Weber; Heiner C Bucher; Jacques Fellay; Amalio Telenti; Philip E Tarr Journal: Clin Infect Dis Date: 2013-03-26 Impact factor: 9.079
Authors: Lawrence A Kingsley; Juliana Cuervo-Rojas; Alvaro Muñoz; Frank J Palella; Wendy Post; Mallory D Witt; Matthew Budoff; Lewis Kuller Journal: AIDS Date: 2008-08-20 Impact factor: 4.177