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

Nadine Jaschinski; Lauren Greenberg; Bastian Neesgaard; Jose M Miró; Katharina Grabmeier-Pfistershammer; Gilles Wandeler; Colette Smith; Stéphane De Wit; Ferdinand Wit; Annegret Pelchen-Matthews; Cristina Mussini; Antonella Castagna; Christian Pradier; Antonella Monforte; Jörg Vehreschild; Anders Sönnerborg; Alain Volny Anne; Andrew Carr; Loveleen Bansi-Matharu; Jens Lundgren; Harmony Garges; Felipe Rogatto; Robert Zangerle; Huldrych F Günthard; Line D Rasmussen; Coca Nescoi; Marc Van Der Valk; Marianna Menozzi; Camilla Muccini; Amanda Mocroft; Lars Peters; Lene Ryom; RESPOND Study Group

doi:10.1097/QAD.0000000000003373

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

Nadine Jaschinski, Lauren Greenberg, Bastian Neesgaard, Jose M Miró, Katharina Grabmeier-Pfistershammer, Gilles Wandeler, Colette Smith, Stéphane De Wit, Ferdinand Wit, Annegret Pelchen-Matthews, Cristina Mussini, Antonella Castagna, Christian Pradier, Antonella Monforte, Jörg Vehreschild, Anders Sönnerborg, Alain Volny Anne, Andrew Carr, Loveleen Bansi-Matharu, Jens LundgrenHarmony Garges, Felipe Rogatto, Robert Zangerle, Huldrych F Günthard, Line D Rasmussen, Coca Nescoi, Marc Van Der Valk, Marianna Menozzi, Camilla Muccini, Amanda Mocroft, Lars Peters, Lene Ryom, RESPOND Study Group

Abstract

OBJECTIVE: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.

DESIGN: Multinational cohort collaboration.

METHODS: RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the 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 the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.

RESULTS: Of 29 340 individuals, 34% recently used ABC. Compared with 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 of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with 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.

Original language	English
Journal	AIDS
Volume	37
Issue number	3
Pages (from-to)	467-475
Number of pages	9
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0000000000003373
Publication status	Published - 1 Mar 2023

Keywords

Cardiovascular Diseases/chemically induced
Disease Progression
HIV Infections/complications
Humans
Renal Insufficiency, Chronic/complications
Risk Factors

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10.1097/QAD.0000000000003373

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Jaschinski, N., Greenberg, L., Neesgaard, B., Miró, J. M., Grabmeier-Pfistershammer, K., Wandeler, G., Smith, C., De Wit, S., Wit, F., Pelchen-Matthews, A., Mussini, C., Castagna, A., Pradier, C., Monforte, A., Vehreschild, J., Sönnerborg, A., Anne, A. V., Carr, A., Bansi-Matharu, L., ... RESPOND Study Group (2023). Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV. AIDS, 37(3), 467-475. https://doi.org/10.1097/QAD.0000000000003373

Jaschinski, N, Greenberg, L, Neesgaard, B, Miró, JM, Grabmeier-Pfistershammer, K, Wandeler, G, Smith, C, De Wit, S, Wit, F, Pelchen-Matthews, A, Mussini, C, Castagna, A, Pradier, C, Monforte, A, Vehreschild, J, Sönnerborg, A, Anne, AV, Carr, A, Bansi-Matharu, L, Lundgren, J, Garges, H, Rogatto, F, Zangerle, R, Günthard, HF, Rasmussen, LD, Nescoi, C, Van Der Valk, M, Menozzi, M, Muccini, C, Mocroft, A , Peters, L , Ryom, L & RESPOND Study Group 2023, 'Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV', AIDS, vol. 37, no. 3, pp. 467-475. https://doi.org/10.1097/QAD.0000000000003373

@article{0ad673c73dd74aa39548ec2e17f7a0eb,

title = "Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV",

abstract = "OBJECTIVE: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.DESIGN: Multinational cohort collaboration.METHODS: RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the 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 the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.RESULTS: Of 29 340 individuals, 34% recently used ABC. Compared with 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 of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with 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.",

keywords = "Cardiovascular Diseases/chemically induced, Disease Progression, HIV Infections/complications, Humans, Renal Insufficiency, Chronic/complications, Risk Factors",

author = "Nadine Jaschinski and Lauren Greenberg and Bastian Neesgaard and Mir{\'o}, {Jose M} and Katharina Grabmeier-Pfistershammer and Gilles Wandeler and Colette Smith and {De Wit}, St{\'e}phane and Ferdinand Wit and Annegret Pelchen-Matthews and Cristina Mussini and Antonella Castagna and Christian Pradier and Antonella Monforte and J{\"o}rg Vehreschild and Anders S{\"o}nnerborg and Anne, {Alain Volny} and Andrew Carr and Loveleen Bansi-Matharu and Jens Lundgren and Harmony Garges and Felipe Rogatto and Robert Zangerle and G{\"u}nthard, {Huldrych F} and Rasmussen, {Line D} and Coca Nescoi and {Van Der Valk}, Marc and Marianna Menozzi and Camilla Muccini and Amanda Mocroft and Lars Peters and Lene Ryom and {RESPOND Study Group}",

year = "2023",

month = mar,

day = "1",

doi = "10.1097/QAD.0000000000003373",

language = "English",

volume = "37",

pages = "467--475",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams & Wilkins",

number = "3",

}

TY - JOUR

T1 - Recent abacavir use and incident cardiovascular disease in contemporary-treated people with HIV

AU - Jaschinski, Nadine

AU - Greenberg, Lauren

AU - Neesgaard, Bastian

AU - Miró, Jose M

AU - Grabmeier-Pfistershammer, Katharina

AU - Wandeler, Gilles

AU - Smith, Colette

AU - De Wit, Stéphane

AU - Wit, Ferdinand

AU - Pelchen-Matthews, Annegret

AU - Mussini, Cristina

AU - Castagna, Antonella

AU - Pradier, Christian

AU - Monforte, Antonella

AU - Vehreschild, Jörg

AU - Sönnerborg, Anders

AU - Anne, Alain Volny

AU - Carr, Andrew

AU - Bansi-Matharu, Loveleen

AU - Lundgren, Jens

AU - Garges, Harmony

AU - Rogatto, Felipe

AU - Zangerle, Robert

AU - Günthard, Huldrych F

AU - Rasmussen, Line D

AU - Nescoi, Coca

AU - Van Der Valk, Marc

AU - Menozzi, Marianna

AU - Muccini, Camilla

AU - Mocroft, Amanda

AU - Peters, Lars

AU - Ryom, Lene

AU - RESPOND Study Group

PY - 2023/3/1

Y1 - 2023/3/1

N2 - OBJECTIVE: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.DESIGN: Multinational cohort collaboration.METHODS: RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the 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 the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.RESULTS: Of 29 340 individuals, 34% recently used ABC. Compared with 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 of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with 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.

AB - OBJECTIVE: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people with HIV.DESIGN: Multinational cohort collaboration.METHODS: RESPOND participants were followed from the latest of 1 January 2012 or cohort enrolment until the first of a CVD event (myocardial infarction, stroke, invasive cardiovascular procedure), last follow-up or 31 December 2019. Logistic regression examined the 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 the past 6 months) and risk of CVD with negative binomial regression models, adjusted for potential confounders.RESULTS: Of 29 340 individuals, 34% recently used ABC. Compared with 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 of median follow-up (interquartile range; 3.87-7.52), there were 748 CVD events (incidence rate 4.7 of 1000 persons-years of follow up (4.3-5.0)]. The adjusted CVD incidence rate ratio was higher for individuals with recent ABC use [1.40 (1.20-1.64)] compared with 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.

KW - Cardiovascular Diseases/chemically induced

KW - Disease Progression

KW - HIV Infections/complications

KW - Humans

KW - Renal Insufficiency, Chronic/complications

KW - Risk Factors

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U2 - 10.1097/QAD.0000000000003373

DO - 10.1097/QAD.0000000000003373

M3 - Journal article

C2 - 36001525

VL - 37

SP - 467

EP - 475

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 3

ER -

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

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