Protease inhibitor exposure and increased risk of cardiovascular disease in HIV-infected patients

被引:104
作者
Iloeje, UH
Yuan, Y
L'Italien, G
Mauskopf, J
Holmberg, SD
Moorman, AC
Wood, KC
Moore, RD
机构
[1] Bristol Myers Squibb Co, Pharmaceut Res Inst, Wallingford, CT 06492 USA
[2] Bristol Myers Squibb Co, Pharmaceut Res Inst, Plainsboro, NJ USA
[3] Res Triangle Inst, Res Triangle Pk, NC 27709 USA
[4] Ctr Dis Control & Prevent, Atlanta, GA USA
[5] Cerner Corp, Vienna, Austria
[6] Johns Hopkins Univ, Inst Med, Baltimore, MD 21218 USA
关键词
antiretroviral therapy; cardiovascular disease; HAART; protease inhibitors; treatment complications;
D O I
10.1111/j.1468-1293.2005.00265.x
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives To study the relationship between exposure to protease inhibitor (PI) therapy and increased risk of cardiovascular events in HIV-infected patients. Methods We estimated the risk of cardiovascular disease (CVD) events with PI exposure in a cohort of HIV-infected patients using a time-dependent Cox proportional hazards model adjusting for the major CVD risk factors. Only the first CVD event for each subject was counted. Results Of a total of 7542 patients, 77% were exposed to Pls. CVD event rates were 9.8/1000 and 6.5/1000 person-years of follow-up (PYFU) in the PI-exposed and nonexposed groups, respectively (P = 0.0008). PI exposure greater than or equal to 60 days was associated with an increased risk of CVD event [adjusted hazards ratio (HRadj) 1.71; 95% confidence interval (CI) 1.08-2.74; P = 0.03]. Results from a subgroup of patients aged between 35 and 65 years were similar (HRadj 1.90; 95% CI 1.13-3.20; P = 0.02). Other significant risk factors included smoking status, age, hypertension, diabetes mellitus and pre-existing CVD. Conclusions Patients exposed to PI therapy had an increased risk of CVD events. Clinicians should evaluate the risk of CVD when making treatment decisions for HIV-infected patients.
引用
收藏
页码:37 / 44
页数:8
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