• Online Features  This Article  • Full text  • PDF  • eTables  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (25)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • HIV/AIDS  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Drug Therapy  • Adverse Effects  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

A Case-Control Study Nested Within the French Hospital Database on HIV ANRS Cohort CO4

Sylvie Lang, MSc; Murielle Mary-Krause, PhD; Laurent Cotte, MD; Jacques Gilquin, MD; Marialuisa Partisani, MD; Anne Simon, MD; Franck Boccara, MD, PhD; Dominique Costagliola, PhD; for the Clinical Epidemiology Group of the French Hospital Database on HIV

Arch Intern Med. 2010;170(14):1228-1238. doi:10.1001/archinternmed.2010.197

Background  The role of exposure to specific antiretroviral drugs on risk of myocardial infarction in human immunodeficiency virus (HIV)–infected patients is debated in the literature.

Methods  To assess whether we confirmed the association between exposure to abacavir and risk of myocardial infarction (MI) and to estimate the impact of exposure to other nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs), and non-NRTIs on risk of MI, we conducted a case-control study nested within the French Hospital Database on HIV. Cases (n = 289) were patients who, between January 2000 and December 2006, had a prospectively recorded first definite or probable MI. Up to 5 controls (n = 884), matched for age, sex, and clinical center, were selected at random with replacement among patients with no history of MI already enrolled in the database when MI was diagnosed in the corresponding case. Conditional logistic regression models were used to adjust for potential confounders.

Results  Short-term/recent exposure to abacavir was associated with an increased risk of MI in the overall sample (odds ratios [ORs], 2.01; 95% confidence interval [CI], 1.11-3.64) but not in the subset of matched cases and controls (81%) who did not use cocaine or intravenous drugs (1.27; 0.64-2.49). Cumulative exposure to all PIs except saquinavir was associated with an increased risk of MI significant for amprenavir/fosamprenavir with or without ritonavir (OR, 1.53; 95% CI, 1.21-1.94 per year) and lopinavir with ritonavir (1.33; 1.09-1.61 per year). Exposure to all non-NRTIs was not associated with risk of MI.

Conclusion  The risk of MI was increased by cumulative exposure to all the studied PIs except saquinavir and particularly to amprenavir/fosamprenavir with or without ritonavir and lopinavir with ritonavir, whereas the association with abacavir cannot be considered causal.

Author Affiliations: Unité 943, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (Ms Lang and Drs Mary-Krause and Costagliola); Unité Mixte de Recherche Santé 943, Université Pierre et Marie Curie, Univ Paris 6, Paris (Ms Lang and Drs Mary-Krause and Costagliola); Service d’hépatologie, Hôtel Dieu, Hospice Civil de Lyon, Lyon, France (Dr Cotte); Service des maladies infectieuses et tropicales, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Paris (Dr Gilquin); Hôpital de jour du Comité de Coordination de la lutte contre l’infection par le vih, Hôpitaux Universitaires de Strasbourg, Strasbourg, France (Dr Partisani); Service de médecine interne 1 (Dr Simon) and Service des maladies infectieuses et tropicales (Dr Costagliola), Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris; and Service de cardiologie, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris (Dr Boccara).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Adverse Outcome Analyses of Observational Data: Assessing Cardiovascular Risk in HIV Disease
Triant et al.
Clinical Infectious Diseases 2012;54:408-413.
ABSTRACT | FULL TEXT  

Morbidity and Aging in HIV-Infected Persons: The Swiss HIV Cohort Study
Hasse et al.
Clinical Infectious Diseases 2011;53:1130-1139.
ABSTRACT | FULL TEXT  

Increased Platelet Reactivity in HIV-1-Infected Patients Receiving Abacavir-Containing Antiretroviral Therapy
Satchell et al.
The Journal of Infectious Disease 2011;204:1202-1210.
ABSTRACT | FULL TEXT  

Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir
Bommenel et al.
J Antimicrob Chemother 2011;66:1869-1877.
ABSTRACT | FULL TEXT  

Complications of HIV infection in an ageing population: challenges in managing older patients on long-term combination antiretroviral therapy
Zhao and Goetz
J Antimicrob Chemother 2011;66:1210-1214.
ABSTRACT | FULL TEXT  

No Risk of Myocardial Infarction Associated With Initial Antiretroviral Treatment Containing Abacavir: Short and Long-Term Results from ACTG A5001/ALLRT
Ribaudo et al.
Clinical Infectious Diseases 2011;52:929-940.
ABSTRACT | FULL TEXT  

Comparison of phenotypic and genotypic tropism determination in triple-class-experienced HIV patients eligible for maraviroc treatment
Vandekerckhove et al.
J Antimicrob Chemother 2011;66:265-272.
ABSTRACT | FULL TEXT  

Antiretrovirals and Risk for Myocardial Infarction
AIDS Clin Care 2010;2010:1-1.
FULL TEXT