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Recent abacavir use and incident cardiovascular disease in contemporary treated people living with HIV

Jaschinski, Nadine; Greenberg, Lauren; Neesgaard, Bastian; Miró, Jose M; Grabmeier-Pfistershammer, Katharina; Wandeler, Gilles; Smith, Colette; ... RESPOND Study Group, .; + view all (2022) Recent abacavir use and incident cardiovascular disease in contemporary treated people living with HIV. AIDS 10.1097/QAD.0000000000003373. (In press). Green open access

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Abstract

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.

Type: Article
Title: Recent abacavir use and incident cardiovascular disease in contemporary treated people living with HIV
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000003373
Publisher version: https://doi.org/10.1097/QAD.0000000000003373
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10154832
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