Changes over time in risk factors for cardiovascular disease and use of lipid-lowering drugs in HIV-infected individuals and impact on myocardial infarction

C. A. Sabin, A. D.Arminio Monforte, N. Friis Moller, R. Weber, W. M.El Sadr, P. Reiss, O. Kirk, P. Mercie, M. G. Law, S. De Wit, C. Pradier, A. N. Phillips, J. D. Lundgren, J. D. Lundgren, S. Collins, E. Loeliger, R. Tressler, I. Weller, N. Friis-Møller, S. W. WormC. A. Sabin, A. Sjøl, J. D. Lundgren, A. Sawitz, M. Rickenbach, P. Pezzotti, E. Krum, L. Gras, E. Balestre, A. Sundström, B. Poll, E. Fontas, F. Torres, K. Petoumenos, J. Kjr, F. De Wolf, S. Zaheri, L. Gras, W. Bronsveld, M. E. Hillebrand-Haverkort, J. M. Prins, J. C. Bos, J. K.M.Eeftinck Schattenkerk, S. E. Geerlings, M. H. Godfried, J. M.A. Lange, F. C.Van Leth, S. H. Lowe, J. T.M.Van Der Meer, F. J.B. Nellen, K. Pogány, T. Van Der Poll, P. Reiss, Th A. Ruys, S. Sankatsing, R. Steingrover, G. Van Twillert, M. Van Der Valk, M. G. Van Vonderen, S. M.E. Vrouenraets, M. Van Vugt, F. W.M.N. Wit, A. Van Eeden, J. H.Ten Veen, P. S.Van Dam, J. C. Roos, K. Brinkman, P. H.J. Frissen, H. M. Weigel, J. W. Mulder, P. L. Meenhorst, A. T.A. Mairuhu, J. Veenstra, S. A. Danner, M. A.Van Agtmael, F. A.P. Claessen, R. M. Perenboom, A. Rijkeboer, M. Van Vonderen, C. Richter, J. Van Der Berg, R. Van Leusen, R. Vriesendorp, F. J.F. Jeurissen, R. H. Kauffmann, E. L.W. Koger, B. Bravenboer, C. H.H.Ten Napel, G. J. Kootstra, H. G. Sprenger, W. M.A.J. Miesen, R. Doedens, E. H. Scholvinck, R. W.Ten Kate, D. P.F. Van Houte, M. Polee, F. P. Kroon, P. J. Van Den Broek, J. T.Van Dissel, E. F. Schippers, G. Schreij, S. Van De Geest, A. Verbon, P. P. Koopmans, M. Keuter, F. Post, A. J.A.M. Van Der Ven, M. E. Van Der Ende, I. C. Gyssens, M. Van Der Feltz, J. G. Den Hollander, S. De Marie, J. L. Nouwen, B. J.A. Rijnders, T. E.M. De Vries, J. R. Juttmann, C. Van De Heul, M. E.E. Van Kasteren, E. Elisabeth, M. M.E. Schneider, M. J.M. Bonten, J. C.C. Borleffs, P. M. Ellerbroek, I. M. Hoepelman, C. A.J.J. Jaspers, I. Schouten, C. A.M. Schurink, W. L. Blok, A. A. Tanis, P. H.P. Groeneveld, R. Salamon, J. Beylot, M. Dupon, M. Le Bras, J. L. Pellegrin, J. M. Ragnaud, F. Dabis, G. Chêne, H. Jacqmin Gadda, R. Thiébaut, S. Lawson-Ayayi, V. Lavignolle, E. Balestre, M. J. Blaizeau, M. Decoin, A. M. Formaggio, S. Delveaux, S. Labarerre, B. Uwamaliya, E. Vimard, L. Merchadou, G. Palmer, D. Touchard, D. Dutoit, F. Pereira, B. Boulant, J. Beylot, P. Morlat, N. Bernard, M. Bonarek, F. Bonnet, B. Coadou, P. Gelie, D. Jaubert, C. Nouts, D. Lacoste, M. Dupon, H. Dutronc, G. Cipriano, S. Lafarie, I. Chossat, J. Y. Lacut, B. Leng, J. L. Pellegrin, P. Mercieï, J. F. Viallard, I. Faure, P. Rispal, C. Cipriano, S. Tchamgoueï, M. Le Bras, F. Djossou, D. Malvy, J. P. Pivetaud, J. M. Ragnaud, D. Chambon, C. De La Taille, T. Galperine, S. Lafarie, D. Neau, A. Ochoa, C. Beylot, M. S. Doutre, J. H. Bezian, J. F. Moreau, J. L. Taupin, C. Conri, J. Constans, P. Couzigou, L. Castera, H. Fleury, M. E. Lafon, B. Masquelier, I. Pellegrin, P. Trimoulet, F. Moreau, C. Mestre, C. Series, A. Taytard, M. Law, K. Petoumenos, Jane Anderson, K. Lowe, A. Mijch, K. Watson, N. Roth, H. Wood, M. Bloch, A. Gowers, D. Baker, R. McFarlane, A. Carr, D. Cooper, J. Chuah, W. Fankhauser, S. Mallal, J. Skett, G. Calvo, F. Torres, S. Mateu, P. Domingo, M. A. Sambeat, J. Gatell, E. Del Cacho, J. Cadafalch, M. Fuster, C. Codina, G. Sirera, A. Vaque, N. Clumeck, S. Dewit, M. Gerard, K. Kabeya, D. Konopnicki, A. Libois, M. C. Payen, B. Poll, Y. Van Laethem, J. Neaton, G. Bartsch, W. M. El-Sadr, E. Krum, G. Thompson, D. Wentworth, R. Luskin-Hawk, E. Telzak, W. M. El-Sadr, D. I. Abrams, D. Cohn, N. Markowitz, L. R. Crane, R. Arduino, D. Mushatt, G. Friedland, G. Perez, E. Tedaldi, E. Fisher, F. Gordin, J. Sampson, J. Baxter, O. Kirk, C. H. Olsen, A. Mocroft, A. N. Phillips, J. D. Lundgren, N. Vetter, I. Karpov, A. Vassilenko, N. Clumeck, S. De Wit, B. Poll, R. Colebunders, L. MacHala, H. Rozsypal, D. Sedlacek, J. Nielsen, T. Benfield, J. Gerstoft, T. Katzenstein, A. B.E. Hansen, P. Skinhøj, C. Pedersen, K. Zilmer, C. Katlama, J. P. Viard, P. M. Girard, T. Saint-Marc, P. Vanhems, C. Pradier, F. Dabis, M. Dietrich, C. Manegold, J. Van Lunzen, H. J. Stellbrink, S. Staszewski, M. Bieckel, F. D. Goebel, G. Fätkenheuer, J. Rockstroh, R. E. Schmidt, J. Kosmidis, P. Gargalianos, H. Sambatakou, J. Perdios, G. Panos, A. Filandras, D. Banhegyi, F. Mulcahy, I. Yust, M. Burke, D. Turner, S. Pollack, J. Hassoun, Z. Sthoeger, S. Maayan, S. Vella, A. Chiesi, C. Arici, R. Pristeraï, F. Mazzotta, A. Gabbuti, R. Esposito, A. Bedini, A. Chirianni, E. Montesarchio, V. Vullo, P. Santopadre, P. Narciso, A. Antinori, P. Franci, M. Zaccarelli, A. Lazzarin, A. Castagna, L. Viksna, S. Chaplinskas, R. Hemmer, T. Staub, P. Reiss, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, A. Horban, D. Prokopowicz, A. Wiercinska-Drapalo, A. Boron-Kaczmarska, M. Pynka, M. Beniowski, E. Mularska, H. Trocha, F. Antunes, K. Mansinho, F. Maltez, D. Duiculescu, V. Babes, A. Streinu-Cercel, E. Vinogradova, A. Rakhmanova, D. Jevtovic, M. Mokrás, D. Stanekovaï, J. González Lahoz, M. Sanchez-Conde, T. Garciá-Benayas, L. Martin-Carbonero, V. Soriano, B. Clotet, A. Jou, J. Conejero, L. Ruiz, C. Tural, J. M. Gatell, J. M. Miroï, L. Zamora, A. Blaxhult, A. Karlsson, P. Pehrson, B. Ledergerber, R. Weber, P. Francioli, A. Telenti, B. Hirschel, V. Soravia-Dunand, H. Furrer, E. Kravchenko, N. Chentsova, M. Fisher, R. Brettle, S. Barton, A. M. Johnson, D. Mercey, M. Murphy, M. A. Johnson, J. Weber, G. Scullard, B. A.°. Kerlund, K. Koppel, A. Karlsson, L. Flamholc, C. Ha°kanga°rd, P. Pezzotti, M. Moroni, A. Cargnel, S. Merli, G. Rizzardini, C. Pastecchia, A. Lazzarin, A. Castagna, L. Caggese, C. Moioli, M. S. Mura, M. Mannazzu, F. Suter, P. E. Manconi, P. Piano, F. Mazzotta, S. Lo Caputo, A. Poggiom, G. Bottari, G. Pagano, A. Alessandrini, A. Scasso, A. Vincenti, V. Abbadessa, S. Mancuso, F. Alberici, A. Ruggieri, M. Arlotti, P. Ortolani, F. De Lalla, G. Tositti, G. Cassola, R. Piscopo, E. Raise, F. Ebo, F. Soscia, L. Tacconi, U. Tirelli, G. Di Gennaro, D. Santoro, L. Pusterla, G. Carosi, C. Torti, G. Cadeo, D. Bertelli, G. Carnevale, D. Galloni, G. Filice, R. Bruno, G. Di Perri, I. Arnaudo, P. Caramello, G. C. Orofino, M. L. Soranzo, M. Bonasso, T. Quirino, S. Melzi, F. Chiodo, V. Colangeli, G. Magnani, M. Ursitti, F. Menichetti, C. Martinelli, R. Esposito, C. Mussini, F. Ghinelli, L. Sighinolfi, O. Coronado, G. Ballardini, E. Rizzo, M. Montroni, M. C. Braschi, E. Petrelli, A. Cioppi, R. Cauda, A. De Luca, N. Petrosillo, P. Noto, P. Narciso, G. Bontempo, A. Afriz, R. Acinapura, G. Antonucci, P. De Longis, V. Vullo, M. Lichtner, G. Pastore, N. Ladisa, A. Chirianni, R. Viglietti, M. Piazza, S. Nappa, N. Abrescia, M. De Marco, A. Colomba, T. Prestileo, C. De Stefano, A. La Gala, L. Cosco, A. Scerbo, P. Grima, P. Tundo, J. Vecchiet, M. D'Alessandro, B. Grisorio, S. Ferrara, C. Pradier, E. Fontas, C. Caissotti, P. Dellamonica, L. Bentz, E. Bernard, F. De Salvador-Guillouet, J. Durant, V. Mondain-Miton, I. Perbost, B. Prouvost-Keller, P. Pugliese, V. Rahelinirina, P. M. Roger, F. Vandenbos, M. Battegay, E. Bernasconi, J. Böni, H. Bucher, Ph Bürgisser, S. Cattacin, M. Cavassini, R. Dubs, M. Egger, L. Elzi, P. Erb, M. Fischer, M. Flepp, A. Fontana, P. Francioli, H. J. Furrer, M. Gorgievski, H. Günthard, B. Hirschel, L. Kaiser, C. Kind, Th Klimkait, U. Lauper, B. Ledergerber, M. Opravil, F. Paccaud, G. Pantaleo, L. Perrin, J. C. Piffaretti, M. Rickenbach, C. Rudin P. Schmid, J. Schüpbach, R. Speck, A. Telenti, A. Trkola, P. Vernazza, R. Weber, S. Yerly

    Research output: Contribution to journalArticlepeer-review

    53 Citations (Scopus)

    Abstract

    Background. Because of the known relationship between exposure to combination antiretroviral therapy and cardiovascular disease (CVD), it has become increasingly important to intervene against risk of CVD in human immunodeficiency virus (HIV)-infected patients. We evaluated changes in risk factors for CVD and the use of lipid-lowering therapy in HIV-infected individuals and assessed the impact of any changes on the incidence of myocardial infarction. Methods. The Data Collection on Adverse Events of Anti-HIV Drugs Study is a collaboration of 11 cohorts of HIV-infected patients that included follow-up for 33,389 HIV-infected patients from December 1999 through February 2006. Results. The proportion of patients at high risk of CVD increased from 35.3% during 1999-2000 to 41.3% during 2005-2006. Of 28,985 patients, 2801 (9.7%) initiated lipid-lowering therapy; initiation of lipid-lowering therapy was more common for those with abnormal lipid values and those with traditional risk factors for CVD (male sex, older age, higher body mass index [calculated as the weight in kilograms divided by the square of the height in meters], family and personal history of CVD, and diabetes mellitus). After controlling for these, use of lipid-lowering drugs became relatively less common over time. The incidence of myocardial infarction (0.32 cases per 100 person-years [PY]; 95% confidence interval [CI], 0.29-0.35 cases per 100 PY) appeared to remain stable. However, after controlling for changes in risk factors for CVD, the rate decreased over time (relative rate in 2003 [compared with 1999-2000], 0.73 cases per 100 PY [95% CI, 0.50-1.05 cases per 100 PY]; in 2004, 0.64 cases per 100 PY [95% CI, 0.44-0.94 cases per 100 PY]; in 2005-2006, 0.36 cases per 100 PY [95% CI, 0.24-0.56 cases per 100 PY]). Further adjustment for lipid levels attenuated the relative rates towards unity (relative rate in 2003 [compared with 1999-2000], 1.06 cases per 100 PY [95% CI, 0.63-1.77 cases per 100 PY]; in 2004, 1.02 cases per 100 PY [95% CI, 0.61-1.71 cases per 100 PY]; in 2005-2006, 0.63 cases per 100 PY [95% CI, 0.36-1.09 cases per 100 PY]). Conclusions. Although the CVD risk profile among patients in the Data Collection on Adverse Events of Anti- HIV Drugs Study has decreased since 1999, rates have remained relatively stable, possibly as a result of a more aggressive approach towards managing the risk of CVD.

    Original languageEnglish
    Pages (from-to)1101-1110
    Number of pages10
    JournalClinical Infectious Diseases
    Volume46
    Issue number7
    DOIs
    Publication statusPublished - 1 Apr 2008

    Fingerprint

    Dive into the research topics of 'Changes over time in risk factors for cardiovascular disease and use of lipid-lowering drugs in HIV-infected individuals and impact on myocardial infarction'. Together they form a unique fingerprint.

    Cite this