@article{42fbc9789b0d4724bbd57baedc838397,
title = "An updated prediction model of the global risk of cardiovascular disease in HIV-positive persons: The Data-collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study: European Journal of Preventive Cardiology",
abstract = "Background With the aging of the population living with HIV, the absolute risk of cardiovascular disease (CVD) is increasing. There is a need to further facilitate the identification of persons at elevated risk in routine practice. Methods and results Prospective information was collected on 32,663 HIV-positive persons from 20 countries in Europe and Australia, who were free of CVD at entry into the Data-collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study. Cox regression models (full and reduced) were developed that predict the risk of a global CVD endpoint. The predictive performance of the D:A:D models were compared with a recent CVD prediction model from the Framingham study, which was assessed recalibrated to the D:A:D dataset. A total of 1010 CVD events occurred during 186,364.5 person-years. The full D:A:D CVD prediction model included age, gender, systolic blood pressure, smoking status, family history of CVD, diabetes, total cholesterol, high-density lipoprotein, CD4 lymphocyte count, cumulative exposure to protease- and nucleoside reverse transcriptase-inhibitors, and current use of abacavir. A reduced model omitted antiretroviral therapies. The D:A:D models statistically significantly predicted risk more accurately than the recalibrated Framingham model (Harrell's c-statistic of 0.791, 0.783 and 0.766 for the D:A:D full, D:A:D reduced, and Framingham models respectively; p < 0.001). The D:A:D models also more accurately predicted five-year CVD-risk for key prognostic subgroups. Conclusions An updated, easily recalibrated, global CVD-risk equation tailored to HIV-positive persons was developed using routinely collected CVD risk parameters and incorporating markers on immune function (CD4 lymphocyte count), and exposure to antiretroviral therapies. The estimated CVD risk can be used to quantify risk and to guide preventive care. {\textcopyright} 2014 European Society of Cardiology.",
keywords = "AIDS, CVD risk prediction, epidemiology, HIV, abacavir, cholesterol, high density lipoprotein, indinavir, lopinavir, proteinase inhibitor, RNA directed DNA polymerase inhibitor, 2',3' dideoxynucleoside derivative, Human immunodeficiency virus proteinase inhibitor, adult, age, Article, cardiovascular disease, cardiovascular risk, CD4 lymphocyte count, cholesterol blood level, clinical trial, diabetes mellitus, family history, female, Framingham risk score, gender, human, Human immunodeficiency virus infected patient, Human immunodeficiency virus infection, male, prediction, priority journal, proportional hazards model, smoking, systolic blood pressure, blood, blood pressure, Cardiovascular Diseases, genetic predisposition, HIV Infections, middle aged, multicenter study, prospective study, risk assessment, sex difference, statistical model, Adult, Age Factors, Blood Pressure, CD4 Lymphocyte Count, Cholesterol, Diabetes Mellitus, Dideoxynucleosides, Female, Genetic Predisposition to Disease, HIV Protease Inhibitors, Humans, Lipoproteins, HDL, Male, Middle Aged, Models, Statistical, Prospective Studies, Reverse Transcriptase Inhibitors, Risk Assessment, Sex Factors, Smoking",
author = "N. Friis-M{\o}ller and L. Ryom and C. Smith and R. Weber and P. Reiss and F. Dabis and {De Wit}, S. and A.D. Monforte and O. Kirk and E. Fontas and C. Sabin and A. Phillips and J. Lundgren and M. Law and Ferran Torres",
note = "Cited By :129 Export Date: 17 February 2022 Correspondence Address: Friis-M{\o}ller, N.; Odense University Hospital, Denmark; email: nina.friis-moeller@rsyd.dk Chemicals/CAS: abacavir, 136470-78-5, 188062-50-2; cholesterol, 57-88-5; indinavir, 150378-17-9, 157810-81-6, 180683-37-8; lopinavir, 192725-17-0; proteinase inhibitor, 37205-61-1; abacavir; Cholesterol; Dideoxynucleosides; HIV Protease Inhibitors; Lipoproteins, HDL; Reverse Transcriptase Inhibitors Funding details: CT94-1637, CT97-2713 Funding details: CURE/97-46486 Funding details: National Institutes of Health, NIH Funding details: U.S. Food and Drug Administration, FDA Funding details: National Institute of Allergy and Infectious Diseases, NIAID, U01AI042170, U01AI046362, U01AI069907 Funding details: Bristol-Myers Squibb, BMS Funding details: Pfizer Funding details: GlaxoSmithKline, GSK Funding details: Merck Funding details: Roche Funding details: Gilead Sciences Funding details: AbbVie Funding details: Boehringer Ingelheim Funding details: Janssen Pharmaceuticals Funding details: Merck Sharp and Dohme, MSD Funding details: ViiV Healthcare Funding details: European Commission, EC Funding details: Schweizerischer Nationalfonds zur F{\~A}¶rderung der Wissenschaftlichen Forschung, SNSF Funding details: University of New South Wales, UNSW Funding details: Agence Nationale de Recherches sur le Sida et les H{\~A}{\textcopyright}patites Virales, ANRS Funding details: Fifth Framework Programme, FP5, QLK2-2000-00773 Funding details: Fundaci{\~A}³n para la Investigaci{\~A}³n y la Prevenci{\~A}³n del Sida en Espa{\~A}±a, FIPSE, 5U01AI042170-10, 5U01AI046362-03, FIPSE 3171/00 Funding details: Instituto de Investigaci{\~A}³n Sanitaria Fundaci{\~A}³n Jim{\~A}{\textcopyright}nez D{\~A}az, IIS-FJD, FIS 99/0887 Funding text 1: This work was supported by the Highly Active Antiretroviral Therapy Oversight Committee (HAART-OC), a collaborative committee with representation from academic institutions, the European Agency for the Evaluation of Medicinal Products, the United States Food and Drug Administration, the patient community, and all pharmaceutical companies with licensed anti-HIV drugs in the European Union: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Viiv Healthcare, Merck, Pfizer, F Hoffman-LaRoche and Janssen Pharmaceuticals. Supported by the Health Insurance Fund Council, Amstelveen, the Netherlands (grant number CURE/97-46486 to the AIDS Therapy Evaluation Project Netherlands (ATHENA)); by the Agence Nationale de Recherches sur le SIDA (grant number Action Coordonn{\'e}e no. 7, Cohortes to the Aquitaine Cohort); The Australian HIV Observational Database (AHOD) is funded as part of the Asia Pacific HIV Observational Database, a programme of The Foundation for AIDS Research, amfAR, and is supported in part by a grant from the US National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases (NIAID) (grant number U01-AI069907) and by unconditional grants from Merck Sharp & Dohme; Gilead Sciences; Bristol-Myers Squibb; Boehringer Ingelheim Roche; Pfizer; GlaxoSmithKline; Janssen Pharmaceuticals. The Kirby Institute is funded by The Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales. Supported by the Fondo de Investigaci{\'o}n Sanitaria (grant number FIS 99/0887) and Fundaci{\'o}n para la Investigaci{\'o}n y la Prevenci{\'o}n del SIDA en Espan{\~a} (grant number FIPSE 3171/00 to the Barcelona Antiretroviral Surveillance Study (BASS)); by the National Institute of Allergy and Infectious Diseases, National Institutes of Health (grants number 5U01AI042170-10, 5U01AI046362-03, to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA)); by the BIOMED 1 (grant number CT94-1637) and BIOMED 2 (grant number CT97-2713) programmes and the fifth framework programme (grant number QLK2-2000-00773) of the European Commission; grants from Bristol-Myers Squibb, GlaxoSmithKline, Boehringer Ingelheim and Roche, to the EuroSIDA study; by unrestricted educational grants of AbbVie, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer, Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretrovirals (The ICONA Foundation); and by a grant from the Swiss National Science Foundation, to the Swiss HIV Cohort Study (SHCS). 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year = "2016",
month = jan,
doi = "10.1177/2047487315579291",
language = "English",
volume = "23",
pages = "214--223",
number = "2",
}
