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Article: Comparison of the risks of atherosclerotic events versus death from other causes associated with antiretroviral use

TitleComparison of the risks of atherosclerotic events versus death from other causes associated with antiretroviral use
Authors
KeywordsChemicals And Cas Registry Numbers
Issue Date2006
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.AIDSonline.com
Citation
Aids, 2006, v. 20 n. 15, p. 1941-1950 How to Cite?
AbstractBACKGROUND: Studies considering the risk of atherosclerotic disease (AtD) associated with the use of HAART have reported inconsistent results. METHODS: Data on antiretroviral therapy (ART) use, risk factors for cardiovascular disease (CVD), AtD and death from other causes in 18 603 HIV-infected patients from two established cohorts were evaluated. The relative hazards of AtD and death from other causes were calculated using a proportional hazards competing risks framework. The impact of protease inhibitor (PI)-containing, non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing or PI + NNRTI-containing regimens on these outcomes were compared to nucleoside reverse transcriptase inhibitor (NRTI)-only regimens or stopping therapy, adjusting for known CVD risk factors. RESULTS: In 77 480 person-years of follow-up (median duration 3.49 years) there were 318 AtD events including 92 myocardial infarctions and 2044 deaths. Older age, hypertension, diabetes mellitus, having smoked and HIV disease stage were significantly associated with increased risk of AtD. PI- and NNRTI-containing regimens significantly reduced the joint risk of either AtD or death from other causes compared to NRTI-only or stopping therapy [hazard ratio (HR) for PI-containing ART, 0.76, 95% confidence interval (CI), 0.73-0.78, P< 0.001; NNRTI-containing ART, 0.69, 95% CI, 0.65-0.74; P< 0.001). PI-containing ART was associated with a borderline significant increased risk of myocardial infarction (cause-specific HR for PI-containing ART 1.19, 95% CI, 1.01-1.40, P = 0.04) but not with increased risk of AtD compared to NRTI-only regimens or stopping therapy (cause-specific HR for PI-containing ART, 1.03, 95% CI, 0.95-1.13, P = 0.44). CONCLUSIONS: Overall benefits of PI- and NNRTI-based ART in reducing mortality significantly outweigh any risks of AtD in the 'short-term' follow-up of this study. Traditional cardiac risk factors play an important role in determining AtD risk status. © 2006 Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/92609
ISSN
2015 Impact Factor: 4.407
2015 SCImago Journal Rankings: 3.112
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, GPSen_HK
dc.contributor.authorGhani, ACen_HK
dc.contributor.authorRode, RAen_HK
dc.contributor.authorBartley, LMen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorDa Silva, Ben_HK
dc.contributor.authorDonnelly, CAen_HK
dc.contributor.authorVan Sighem, AIen_HK
dc.contributor.authorCameron, DWen_HK
dc.contributor.authorDanner, SAen_HK
dc.contributor.authorDe Wolf, Fen_HK
dc.contributor.authorAnderson, RMen_HK
dc.date.accessioned2010-09-17T10:51:35Z-
dc.date.available2010-09-17T10:51:35Z-
dc.date.issued2006en_HK
dc.identifier.citationAids, 2006, v. 20 n. 15, p. 1941-1950en_HK
dc.identifier.issn0269-9370en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92609-
dc.description.abstractBACKGROUND: Studies considering the risk of atherosclerotic disease (AtD) associated with the use of HAART have reported inconsistent results. METHODS: Data on antiretroviral therapy (ART) use, risk factors for cardiovascular disease (CVD), AtD and death from other causes in 18 603 HIV-infected patients from two established cohorts were evaluated. The relative hazards of AtD and death from other causes were calculated using a proportional hazards competing risks framework. The impact of protease inhibitor (PI)-containing, non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing or PI + NNRTI-containing regimens on these outcomes were compared to nucleoside reverse transcriptase inhibitor (NRTI)-only regimens or stopping therapy, adjusting for known CVD risk factors. RESULTS: In 77 480 person-years of follow-up (median duration 3.49 years) there were 318 AtD events including 92 myocardial infarctions and 2044 deaths. Older age, hypertension, diabetes mellitus, having smoked and HIV disease stage were significantly associated with increased risk of AtD. PI- and NNRTI-containing regimens significantly reduced the joint risk of either AtD or death from other causes compared to NRTI-only or stopping therapy [hazard ratio (HR) for PI-containing ART, 0.76, 95% confidence interval (CI), 0.73-0.78, P< 0.001; NNRTI-containing ART, 0.69, 95% CI, 0.65-0.74; P< 0.001). PI-containing ART was associated with a borderline significant increased risk of myocardial infarction (cause-specific HR for PI-containing ART 1.19, 95% CI, 1.01-1.40, P = 0.04) but not with increased risk of AtD compared to NRTI-only regimens or stopping therapy (cause-specific HR for PI-containing ART, 1.03, 95% CI, 0.95-1.13, P = 0.44). CONCLUSIONS: Overall benefits of PI- and NNRTI-based ART in reducing mortality significantly outweigh any risks of AtD in the 'short-term' follow-up of this study. Traditional cardiac risk factors play an important role in determining AtD risk status. © 2006 Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.AIDSonline.comen_HK
dc.relation.ispartofAIDSen_HK
dc.subjectChemicals And Cas Registry Numbersen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAnti-Retroviral Agents - adverse effects - therapeutic useen_HK
dc.subject.meshAntiretroviral Therapy, Highly Activeen_HK
dc.subject.meshAtherosclerosis - chemically induced - mortalityen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHIV Infections - complications - drug therapy - mortalityen_HK
dc.subject.meshHIV Protease Inhibitors - adverse effects - therapeutic useen_HK
dc.subject.meshHIV-1en_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProportional Hazards Modelsen_HK
dc.subject.meshReverse Transcriptase Inhibitors - adverse effects - therapeutic useen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSex Factorsen_HK
dc.subject.meshSmokingen_HK
dc.subject.meshTime Factorsen_HK
dc.titleComparison of the risks of atherosclerotic events versus death from other causes associated with antiretroviral useen_HK
dc.typeArticleen_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/01.aids.0000247115.81832.a1en_HK
dc.identifier.pmid16988515-
dc.identifier.scopuseid_2-s2.0-33748886125en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33748886125&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue15en_HK
dc.identifier.spage1941en_HK
dc.identifier.epage1950en_HK
dc.identifier.isiWOS:000244509800006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKwong, GPS=8501951800en_HK
dc.identifier.scopusauthoridGhani, AC=7006814439en_HK
dc.identifier.scopusauthoridRode, RA=7004739315en_HK
dc.identifier.scopusauthoridBartley, LM=6602473514en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridDa Silva, B=11439783100en_HK
dc.identifier.scopusauthoridDonnelly, CA=35468127900en_HK
dc.identifier.scopusauthoridVan Sighem, AI=14824235200en_HK
dc.identifier.scopusauthoridCameron, DW=7402889016en_HK
dc.identifier.scopusauthoridDanner, SA=7006823223en_HK
dc.identifier.scopusauthoridDe Wolf, F=7005022848en_HK
dc.identifier.scopusauthoridAnderson, RM=7408244444en_HK

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