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Clin Infect Dis. 2008 Apr 1;46(7):1101-10. doi: 10.1086/528862.

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

Collaborators (559)

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

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.

PMID:
18461712
[PubMed - indexed for MEDLINE]
PMCID:
PMC2702541
Free PMC Article
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