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Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study

Identifieur interne : 007577 ( Main/Exploration ); précédent : 007576; suivant : 007578

Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study

Auteurs : Signe Westring Worm [Danemark] ; Caroline Sabin [Royaume-Uni] ; Rainer Weber [Suisse] ; Peter Reiss [Pays-Bas] ; Wafaa El-Sadr [États-Unis] ; Francois Dabis [France] ; Stephane De Wit [Belgique] ; Matthew Law [Australie] ; Antonella D'Arminio Monforte [Italie] ; Nina Friis-M Ller [Danemark] ; Ole Kirk [Danemark] ; Eric Fontas [France] ; Ian Weller [Royaume-Uni] ; Andrew Phillips [Royaume-Uni] ; Jens Lundgren [Danemark]

Source :

RBID : Pascal:10-0106148

Descripteurs français

English descriptors

Abstract

Background. The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti-HIV drugs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Methods. Poisson regression models were adjusted for cardiovascular risk factors, cohort, calendar year, and use of other antiretroviral drugs and assessed the association between MI risk and cumulative (per year) or recent (current or in the past 6 months) use of antiretroviral drugs, with >30,000 person-years of exposure. Results. Over 178,835 person-years, 580 patients developed MI. There were no associations between use of tenofovir, zalcitabine, zidovudine, stavudine, or lamivudine and MI risk. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir-ritonavir was associated with an increased risk of MI (relative rate [RR] per year, 1.12 and 1.13, respectively). These increased risks were attenuated slightly (RR per year, 1.08 [95% confidence interval {CI}, 1.02-1.14] and 1.09 [95% CI, 1.01-1.17], respectively) after adjustment for lipids but were not altered further after adjustment for other metabolic parameters. Conclusions. Of the drugs considered, only indinavir, lopinavir-ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI. As with any observational study, our findings must be interpreted with caution (given the potential for confounding) and in the context of the benefits that these drugs provide.


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Le document en format XML

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<name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name>
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<s1>Research Department of Infection and Population Health, University College London</s1>
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<name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name>
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<title xml:lang="en" level="a">Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study</title>
<author>
<name sortKey="Westring Worm, Signe" sort="Westring Worm, Signe" uniqKey="Westring Worm S" first="Signe" last="Westring Worm">Signe Westring Worm</name>
<affiliation wicri:level="3">
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<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
<s2>Copenhagen</s2>
<s3>DNK</s3>
<sZ>1 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
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<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
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<author>
<name sortKey="Sabin, Caroline" sort="Sabin, Caroline" uniqKey="Sabin C" first="Caroline" last="Sabin">Caroline Sabin</name>
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<inist:fA14 i1="02">
<s1>Research Department of Infection and Population Health, University College London</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
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<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
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<author>
<name sortKey="Weber, Rainer" sort="Weber, Rainer" uniqKey="Weber R" first="Rainer" last="Weber">Rainer Weber</name>
<affiliation wicri:level="1">
<inist:fA14 i1="04">
<s1>Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich</s1>
<s2>Zurich</s2>
<s3>CHE</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
<wicri:noRegion>Zurich</wicri:noRegion>
</affiliation>
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<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
<affiliation wicri:level="3">
<inist:fA14 i1="05">
<s1>HIV Monitoring Foundation, Academic Medical Center</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<placeName>
<settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
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<name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name>
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<country>États-Unis</country>
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<region type="state">État de New York</region>
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<name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name>
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<s2>Bordeaux</s2>
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</inist:fA14>
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<placeName>
<region type="region">Nouvelle-Aquitaine</region>
<region type="old region">Aquitaine</region>
<settlement type="city">Bordeaux</settlement>
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<name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name>
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</inist:fA14>
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<placeName>
<settlement type="city">Bruxelles</settlement>
<region nuts="2">Région de Bruxelles-Capitale</region>
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<name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name>
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<country>Australie</country>
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<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
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<name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name>
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<name sortKey="Friis M Ller, Nina" sort="Friis M Ller, Nina" uniqKey="Friis M Ller N" first="Nina" last="Friis-M Ller">Nina Friis-M Ller</name>
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<inist:fA14 i1="01">
<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
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<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
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<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
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<s3>DNK</s3>
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<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
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<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name>
<affiliation wicri:level="3">
<inist:fA14 i1="08">
<s1>Centre Hospitalier Universitaire Nice Hopital de l'Archet</s1>
<s2>Nice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Nice</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Weller, Ian" sort="Weller, Ian" uniqKey="Weller I" first="Ian" last="Weller">Ian Weller</name>
<affiliation wicri:level="4">
<inist:fA14 i1="03">
<s1>Centre for Sexual Health and HIV Research, University College London</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author>
<name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name>
<affiliation wicri:level="4">
<inist:fA14 i1="02">
<s1>Research Department of Infection and Population Health, University College London</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author>
<name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name>
<affiliation wicri:level="3">
<inist:fA14 i1="01">
<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
<s2>Copenhagen</s2>
<s3>DNK</s3>
<sZ>1 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">The Journal of infectious diseases</title>
<title level="j" type="abbreviated">J. infect. dis.</title>
<idno type="ISSN">0022-1899</idno>
<imprint>
<date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">The Journal of infectious diseases</title>
<title level="j" type="abbreviated">J. infect. dis.</title>
<idno type="ISSN">0022-1899</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>AIDS</term>
<term>Antiretroviral agent</term>
<term>Antiviral</term>
<term>Human immunodeficiency virus</term>
<term>Infection</term>
<term>Myocardial infarction</term>
<term>Toxicity</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Virus immunodéficience humaine</term>
<term>Antiviral</term>
<term>Antirétroviral</term>
<term>Toxicité</term>
<term>Infection</term>
<term>Infarctus du myocarde</term>
<term>SIDA</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Background. The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti-HIV drugs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Methods. Poisson regression models were adjusted for cardiovascular risk factors, cohort, calendar year, and use of other antiretroviral drugs and assessed the association between MI risk and cumulative (per year) or recent (current or in the past 6 months) use of antiretroviral drugs, with >30,000 person-years of exposure. Results. Over 178,835 person-years, 580 patients developed MI. There were no associations between use of tenofovir, zalcitabine, zidovudine, stavudine, or lamivudine and MI risk. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir-ritonavir was associated with an increased risk of MI (relative rate [RR] per year, 1.12 and 1.13, respectively). These increased risks were attenuated slightly (RR per year, 1.08 [95% confidence interval {CI}, 1.02-1.14] and 1.09 [95% CI, 1.01-1.17], respectively) after adjustment for lipids but were not altered further after adjustment for other metabolic parameters. Conclusions. Of the drugs considered, only indinavir, lopinavir-ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI. As with any observational study, our findings must be interpreted with caution (given the potential for confounding) and in the context of the benefits that these drugs provide.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Belgique</li>
<li>Danemark</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Aquitaine</li>
<li>Grand Londres</li>
<li>Hollande-Septentrionale</li>
<li>Hovedstaden</li>
<li>Lombardie</li>
<li>Nouvelle-Aquitaine</li>
<li>Nouvelle-Galles du Sud</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Région de Bruxelles-Capitale</li>
<li>État de New York</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Bordeaux</li>
<li>Bruxelles</li>
<li>Copenhague</li>
<li>Londres</li>
<li>Milan</li>
<li>Nice</li>
<li>Sydney</li>
</settlement>
<orgName>
<li>University College de Londres</li>
</orgName>
</list>
<tree>
<country name="Danemark">
<region name="Hovedstaden">
<name sortKey="Westring Worm, Signe" sort="Westring Worm, Signe" uniqKey="Westring Worm S" first="Signe" last="Westring Worm">Signe Westring Worm</name>
</region>
<name sortKey="Friis M Ller, Nina" sort="Friis M Ller, Nina" uniqKey="Friis M Ller N" first="Nina" last="Friis-M Ller">Nina Friis-M Ller</name>
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Sabin, Caroline" sort="Sabin, Caroline" uniqKey="Sabin C" first="Caroline" last="Sabin">Caroline Sabin</name>
</region>
<name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name>
<name sortKey="Weller, Ian" sort="Weller, Ian" uniqKey="Weller I" first="Ian" last="Weller">Ian Weller</name>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Weber, Rainer" sort="Weber, Rainer" uniqKey="Weber R" first="Rainer" last="Weber">Rainer Weber</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Hollande-Septentrionale">
<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
</region>
</country>
<country name="États-Unis">
<region name="État de New York">
<name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name>
</region>
</country>
<country name="France">
<region name="Nouvelle-Aquitaine">
<name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name>
</region>
<name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name>
</country>
<country name="Belgique">
<region name="Région de Bruxelles-Capitale">
<name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name>
</region>
</country>
<country name="Australie">
<region name="Nouvelle-Galles du Sud">
<name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name>
</region>
</country>
<country name="Italie">
<region name="Lombardie">
<name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name>
</region>
</country>
</tree>
</affiliations>
</record>

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