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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Gender differences in HIV-positive persons in use of cardiovascular disease-related interventions: D:A:D study</title><author><name sortKey="Hatleberg, Camilla Ingrid" sort="Hatleberg, Camilla Ingrid" uniqKey="Hatleberg C" first="Camilla Ingrid" last="Hatleberg">Camilla Ingrid Hatleberg</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name><affiliation><nlm:aff id="AF0002_19516">Mailman School of Public Health, Columbia University, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name><affiliation><nlm:aff id="AF0003_19516">Research Department of Infection and Population Health, University College London, London, UK</nlm:aff></affiliation></author><author><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name><affiliation><nlm:aff id="AF0004_19516">Amsterdam Medical Center, University of Amsterdam, Stichting HIV Monitoring, Amsterdam, Netherlands</nlm:aff></affiliation></author><author><name sortKey="De Wit, Stephan" sort="De Wit, Stephan" uniqKey="De Wit S" first="Stephan" last="De Wit">Stephan De Wit</name><affiliation><nlm:aff id="AF0005_19516">CHU Saint-Pierre Hospital, Saint-Pierre Cohort, Brussels, Belgium</nlm:aff></affiliation></author><author><name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name><affiliation><nlm:aff id="AF0006_19516">ISPED, Centre Inserm U897, University of Bordeaux, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name><affiliation><nlm:aff id="AF0007_19516">Department of Public Health, Nice University Hospital, Nice, France</nlm:aff></affiliation></author><author><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><affiliation><nlm:aff id="AF0008_19516">Department of Health Sciences, San Paolo University Hospital, Infectious Diseases Unit, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Rickenbach, Martin" sort="Rickenbach, Martin" uniqKey="Rickenbach M" first="Martin" last="Rickenbach">Martin Rickenbach</name><affiliation><nlm:aff id="AF0009_19516">Institute of Social and Preventive Medicine, University of Lausanne, Swiss Cohort Study, Lausanne, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name><affiliation><nlm:aff id="AF0010_19516">The Kirby Institute, University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Sabin, Caroline" sort="Sabin, Caroline" uniqKey="Sabin C" first="Caroline" last="Sabin">Caroline Sabin</name><affiliation><nlm:aff id="AF0003_19516">Research Department of Infection and Population Health, University College London, London, UK</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25394025</idno><idno type="pmc">4224835</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224835</idno><idno type="RBID">PMC:4224835</idno><idno type="doi">10.7448/IAS.17.4.19516</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001176</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001176</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Gender differences in HIV-positive persons in use of cardiovascular disease-related interventions: D:A:D study</title><author><name sortKey="Hatleberg, Camilla Ingrid" sort="Hatleberg, Camilla Ingrid" uniqKey="Hatleberg C" first="Camilla Ingrid" last="Hatleberg">Camilla Ingrid Hatleberg</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name><affiliation><nlm:aff id="AF0002_19516">Mailman School of Public Health, Columbia University, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name><affiliation><nlm:aff id="AF0003_19516">Research Department of Infection and Population Health, University College London, London, UK</nlm:aff></affiliation></author><author><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name><affiliation><nlm:aff id="AF0004_19516">Amsterdam Medical Center, University of Amsterdam, Stichting HIV Monitoring, Amsterdam, Netherlands</nlm:aff></affiliation></author><author><name sortKey="De Wit, Stephan" sort="De Wit, Stephan" uniqKey="De Wit S" first="Stephan" last="De Wit">Stephan De Wit</name><affiliation><nlm:aff id="AF0005_19516">CHU Saint-Pierre Hospital, Saint-Pierre Cohort, Brussels, Belgium</nlm:aff></affiliation></author><author><name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name><affiliation><nlm:aff id="AF0006_19516">ISPED, Centre Inserm U897, University of Bordeaux, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name><affiliation><nlm:aff id="AF0007_19516">Department of Public Health, Nice University Hospital, Nice, France</nlm:aff></affiliation></author><author><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><affiliation><nlm:aff id="AF0008_19516">Department of Health Sciences, San Paolo University Hospital, Infectious Diseases Unit, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Rickenbach, Martin" sort="Rickenbach, Martin" uniqKey="Rickenbach M" first="Martin" last="Rickenbach">Martin Rickenbach</name><affiliation><nlm:aff id="AF0009_19516">Institute of Social and Preventive Medicine, University of Lausanne, Swiss Cohort Study, Lausanne, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name><affiliation><nlm:aff id="AF0010_19516">The Kirby Institute, University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name><affiliation><nlm:aff id="AF0001_19516">CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</nlm:aff></affiliation></author><author><name sortKey="Sabin, Caroline" sort="Sabin, Caroline" uniqKey="Sabin C" first="Caroline" last="Sabin">Caroline Sabin</name><affiliation><nlm:aff id="AF0003_19516">Research Department of Infection and Population Health, University College London, London, UK</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of the International AIDS Society</title><idno type="eISSN">1758-2652</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1_19516"><title>Introduction</title><p>There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study.</p></sec><sec id="st2_19516"><title>Materials and Methods</title><p>Follow-up was from 01/02/99 until the earliest of death, 6 months after last visit or 01/02/13. Rates of initiation of lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives and receipt of invasive cardiovascular procedures (ICPs; bypass, angioplasty, endarterectomy) were calculated in those without a myocardial infarction (MI) or stroke at baseline, overall and in groups known to be at higher CVD risk: (i) age >50, (ii) total cholesterol >6.2 mmol/l, (iii) triglyceride >2.3 mmol/l, (iv) hypertension, (v) previous MI, (vi) diabetes, or (vii) predicted 10-year CVD risk >10%. Poisson regression was used to assess whether rates of initiation were higher in men than women, after adjustment for these factors.</p></sec><sec id="st3_19516"><title>Results</title><p>At enrolment, women (<italic>n</italic>=13,039; median (interquartile range) 34 (29–40) years) were younger than men (<italic>n</italic>=36,664, 39 (33–46) years, <italic>p</italic>=0.001), and were less likely to be current smokers (29% vs. 39%, <italic>p</italic>=0.0001), to have diabetes (2% vs. 3%, <italic>p</italic>=0.0001) or to have hypertension (7% vs. 11%, <italic>p</italic>=0.0001). Of 49,071 individuals without a MI/stroke at enrolment, 0.6% women vs. 2.1% men experienced a MI while 0.8% vs. 1.3% experienced a stroke. Overall, women received ICPs at a rate of 0.07/100 person-years (PYRS) compared to 0.29/100 PYRS in men. Similarly, the rates of initiation of LLDs (1.28 vs. 2.46), anti-hypertensives (1.11 vs. 1.38) and ACEIs (0.82 vs. 1.37) were all significantly lower in women than men (<xref ref-type="table" rid="T0001_19516">Table 1</xref>). As expected, initiation rates of each intervention were higher in the groups determined to be at moderate/high CVD risk; however, within each high-risk group, initiation rates of most interventions (with the exception of anti-hypertensives) were generally lower in women than men. These gender differences persisted after adjustment for potential confounders (<xref ref-type="table" rid="T0001_19516">Table 1</xref>). </p></sec><sec id="st4_19516"><title>Conclusion</title><p>Use of most CVD interventions was lower among women than men in the D:A:D study. Our findings suggest that actions should be taken to ensure that both men and women are monitored for CVD and, if eligible, receive appropriate CVD interventions.</p></sec></div></front></TEI><pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Int AIDS Soc</journal-id><journal-id journal-id-type="iso-abbrev">J Int AIDS Soc</journal-id><journal-id journal-id-type="publisher-id">JIAS</journal-id><journal-title-group><journal-title>Journal of the International AIDS Society</journal-title></journal-title-group><issn pub-type="epub">1758-2652</issn><publisher><publisher-name>International AIDS Society</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25394025</article-id><article-id pub-id-type="pmc">4224835</article-id><article-id pub-id-type="publisher-id">19516</article-id><article-id pub-id-type="doi">10.7448/IAS.17.4.19516</article-id><article-categories><subj-group subj-group-type="heading"><subject>Oral Presentation – Abstract O324</subject></subj-group></article-categories><title-group><article-title>Gender differences in HIV-positive persons in use of cardiovascular disease-related interventions: D:A:D study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hatleberg</surname><given-names>Camilla Ingrid</given-names></name><xref ref-type="aff" rid="AF0001_19516">1</xref></contrib><contrib contrib-type="author"><name><surname>Ryom</surname><given-names>Lene</given-names></name><xref ref-type="aff" rid="AF0001_19516">1</xref></contrib><contrib contrib-type="author"><name><surname>El-Sadr</surname><given-names>Wafaa</given-names></name><xref ref-type="aff" rid="AF0002_19516">2</xref></contrib><contrib contrib-type="author"><name><surname>Mocroft</surname><given-names>Amanda</given-names></name><xref ref-type="aff" rid="AF0003_19516">3</xref></contrib><contrib contrib-type="author"><name><surname>Reiss</surname><given-names>Peter</given-names></name><xref ref-type="aff" rid="AF0004_19516">4</xref></contrib><contrib contrib-type="author"><name><surname>de Wit</surname><given-names>Stephan</given-names></name><xref ref-type="aff" rid="AF0005_19516">5</xref></contrib><contrib contrib-type="author"><name><surname>Dabis</surname><given-names>Francois</given-names></name><xref ref-type="aff" rid="AF0006_19516">6</xref></contrib><contrib contrib-type="author"><name><surname>Pradier</surname><given-names>Christian</given-names></name><xref ref-type="aff" rid="AF0007_19516">7</xref></contrib><contrib contrib-type="author"><name><surname>d'Arminio Monforte</surname><given-names>Antonella</given-names></name><xref ref-type="aff" rid="AF0008_19516">8</xref></contrib><contrib contrib-type="author"><name><surname>Rickenbach</surname><given-names>Martin</given-names></name><xref ref-type="aff" rid="AF0009_19516">9</xref></contrib><contrib contrib-type="author"><name><surname>Law</surname><given-names>Matthew</given-names></name><xref ref-type="aff" rid="AF0010_19516">10</xref></contrib><contrib contrib-type="author"><name><surname>Lundgren</surname><given-names>Jens</given-names></name><xref ref-type="aff" rid="AF0001_19516">1</xref></contrib><contrib contrib-type="author"><name><surname>Sabin</surname><given-names>Caroline</given-names></name><xref ref-type="aff" rid="AF0003_19516">3</xref></contrib></contrib-group><aff id="AF0001_19516"><label>1</label>CHIP Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark</aff><aff id="AF0002_19516"><label>2</label>Mailman School of Public Health, Columbia University, New York, USA</aff><aff id="AF0003_19516"><label>3</label>Research Department of Infection and Population Health, University College London, London, UK</aff><aff id="AF0004_19516"><label>4</label>Amsterdam Medical Center, University of Amsterdam, Stichting HIV Monitoring, Amsterdam, Netherlands</aff><aff id="AF0005_19516"><label>5</label>CHU Saint-Pierre Hospital, Saint-Pierre Cohort, Brussels, Belgium</aff><aff id="AF0006_19516"><label>6</label>ISPED, Centre Inserm U897, University of Bordeaux, Bordeaux, France</aff><aff id="AF0007_19516"><label>7</label>Department of Public Health, Nice University Hospital, Nice, France</aff><aff id="AF0008_19516"><label>8</label>Department of Health Sciences, San Paolo University Hospital, Infectious Diseases Unit, Milan, Italy</aff><aff id="AF0009_19516"><label>9</label>Institute of Social and Preventive Medicine, University of Lausanne, Swiss Cohort Study, Lausanne, Switzerland</aff><aff id="AF0010_19516"><label>10</label>The Kirby Institute, University of New South Wales, Sydney, Australia</aff><pub-date pub-type="epub"><day>02</day><month>11</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>17</volume><issue>4Suppl 3</issue><elocation-id content-type="doi">19516</elocation-id><permissions><copyright-statement>© 2014 Hatleberg CI et al; licensee International AIDS Society</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec id="st1_19516"><title>Introduction</title><p>There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study.</p></sec><sec id="st2_19516"><title>Materials and Methods</title><p>Follow-up was from 01/02/99 until the earliest of death, 6 months after last visit or 01/02/13. Rates of initiation of lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives and receipt of invasive cardiovascular procedures (ICPs; bypass, angioplasty, endarterectomy) were calculated in those without a myocardial infarction (MI) or stroke at baseline, overall and in groups known to be at higher CVD risk: (i) age >50, (ii) total cholesterol >6.2 mmol/l, (iii) triglyceride >2.3 mmol/l, (iv) hypertension, (v) previous MI, (vi) diabetes, or (vii) predicted 10-year CVD risk >10%. Poisson regression was used to assess whether rates of initiation were higher in men than women, after adjustment for these factors.</p></sec><sec id="st3_19516"><title>Results</title><p>At enrolment, women (<italic>n</italic>=13,039; median (interquartile range) 34 (29–40) years) were younger than men (<italic>n</italic>=36,664, 39 (33–46) years, <italic>p</italic>=0.001), and were less likely to be current smokers (29% vs. 39%, <italic>p</italic>=0.0001), to have diabetes (2% vs. 3%, <italic>p</italic>=0.0001) or to have hypertension (7% vs. 11%, <italic>p</italic>=0.0001). Of 49,071 individuals without a MI/stroke at enrolment, 0.6% women vs. 2.1% men experienced a MI while 0.8% vs. 1.3% experienced a stroke. Overall, women received ICPs at a rate of 0.07/100 person-years (PYRS) compared to 0.29/100 PYRS in men. Similarly, the rates of initiation of LLDs (1.28 vs. 2.46), anti-hypertensives (1.11 vs. 1.38) and ACEIs (0.82 vs. 1.37) were all significantly lower in women than men (<xref ref-type="table" rid="T0001_19516">Table 1</xref>). As expected, initiation rates of each intervention were higher in the groups determined to be at moderate/high CVD risk; however, within each high-risk group, initiation rates of most interventions (with the exception of anti-hypertensives) were generally lower in women than men. These gender differences persisted after adjustment for potential confounders (<xref ref-type="table" rid="T0001_19516">Table 1</xref>). </p></sec><sec id="st4_19516"><title>Conclusion</title><p>Use of most CVD interventions was lower among women than men in the D:A:D study. Our findings suggest that actions should be taken to ensure that both men and women are monitored for CVD and, if eligible, receive appropriate CVD interventions.</p></sec></abstract></article-meta></front><body><table-wrap id="T0001_19516" position="float"><label>Table 1</label><caption><p>Relative rate (RR) of receipt of each of the four interventions in women versus men, before and after adjustment for potential confounders (age, year, BMI, high cholesterol, high triglycerides, hypertension, previous MI, diabetes and moderate/high predicted 10-year Framingham CVD risk score)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"></th><th align="center" rowspan="1" colspan="1">Before adjustment</th><th align="center" rowspan="1" colspan="1">After adjustment</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Intervention</td><td align="left" rowspan="1" colspan="1">RR (95% CI); <italic>p</italic>-value</td><td align="left" rowspan="1" colspan="1">RR (95% CI); <italic>p</italic>-value</td></tr><tr><td align="left" rowspan="1" colspan="1">Lipid-lowering drugs</td><td align="left" rowspan="1" colspan="1">0.52 (0.49, 0.56); <italic>p</italic>=0.0001</td><td align="left" rowspan="1" colspan="1">0.80 (0.75, 0.86); <italic>p</italic>=0.0001</td></tr><tr><td align="left" rowspan="1" colspan="1">ACE inhibitors</td><td align="left" rowspan="1" colspan="1">0.60 (0.56, 0.65); <italic>p</italic>=0.0001</td><td align="left" rowspan="1" colspan="1">0.80 (0.74, 0.87); <italic>p</italic>=0.0001</td></tr><tr><td align="left" rowspan="1" colspan="1">Anti-hypertensives</td><td align="left" rowspan="1" colspan="1">0.81 (0.75, 0.86); <italic>p</italic>=0.0001</td><td align="left" rowspan="1" colspan="1">1.16 (1.07, 1.25); <italic>p</italic>=0.0001</td></tr><tr><td align="left" rowspan="1" colspan="1">ICPs</td><td align="left" rowspan="1" colspan="1">0.25 (0.20, 0.32); <italic>p</italic>=0.0001</td><td align="left" rowspan="1" colspan="1">0.49 (0.38, 0.63); <italic>p</italic>=0.0001</td></tr></tbody></table></table-wrap></body></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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