Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 605-618 |
| Number of pages | 14 |
| Journal | HIV Medicine |
| Volume | 19 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Oct 2018 |
Keywords
- antiretroviral therapy
- cardiovascular disease
- HIV
- hypertension
- abacavir
- anti human immunodeficiency virus agent
- antihypertensive agent
- atazanavir
- darunavir plus ritonavir
- efavirenz
- emtricitabine
- indinavir plus ritonavir
- lamivudine
- lopinavir plus ritonavir
- nelfinavir
- nevirapine
- nonnucleoside reverse transcriptase inhibitor
- proteinase inhibitor
- ritonavir
- RNA directed DNA polymerase inhibitor
- tenofovir
- adult
- antihypertensive therapy
- Article
- cohort analysis
- female
- human
- Human immunodeficiency virus infected patient
- Human immunodeficiency virus infection
- incidence
- major clinical study
- male
- middle aged
- observational study
- priority journal
- risk factor
- chemically induced
- clinical trial
- ethnology
- multicenter study
- regression analysis
- Adult
- Anti-HIV Agents
- Female
- HIV Infections
- Humans
- Hypertension
- Incidence
- Male
- Regression Analysis
- Risk Factors
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TY - JOUR
T1 - Association between exposure to antiretroviral drugs and the incidence of hypertension in HIV-positive persons: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study
T2 - HIV Medicine
AU - Hatleberg, C.I.
AU - Ryom, L.
AU - d'Arminio Monforte, A.
AU - Fontas, E.
AU - Reiss, P.
AU - Kirk, O.
AU - El-Sadr, W.
AU - Phillips, A.
AU - de Wit, S.
AU - Dabis, F.
AU - Weber, R.
AU - Law, M.
AU - Lundgren, J.D.
AU - Sabin, C.
AU - Torres, Ferran
N1 - Cited By :8 Export Date: 17 February 2022 CODEN: HMIEA Correspondence Address: Hatleberg, C.I.; Centre of Excellence for Health, Denmark; email: camilla.hatleberg@regionh.dk Chemicals/CAS: abacavir, 136470-78-5, 188062-50-2; atazanavir, 198904-31-3; efavirenz, 154598-52-4; emtricitabine, 137530-41-7, 143491-54-7, 143491-57-0; lamivudine, 134678-17-4, 134680-32-3; nelfinavir, 159989-64-7, 159989-65-8; nevirapine, 129618-40-2; proteinase inhibitor, 37205-61-1; ritonavir, 155213-67-5; tenofovir, 147127-19-3, 147127-20-6; Anti-HIV Agents Funding details: 260694 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: Styrelsen för Internationellt Utvecklingssamarbete, Sida Funding details: Janssen Research and Development, JRD Funding details: Gilead Sciences Funding details: AbbVie Funding details: Boehringer Ingelheim Funding details: Janssen Pharmaceuticals, 148522 Funding details: Food and Drug Administration, FDA Funding details: Merck Sharp and Dohme, MSD Funding details: ViiV Healthcare Funding details: Cilag Funding details: Energy Market Authority of Singapore, EMA Funding details: Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, SNSF, 108787 Funding details: Danmarks Grundforskningsfond, DNRF Funding details: University of New South Wales, UNSW Funding details: Ministerie van Volksgezondheid, Welzijn en Sport, VWS Funding details: Agence Nationale de Recherches sur le Sida et les Hépatites Virales, ANRS Funding details: Fundación Emilio Soldevilla para la Investigación y el Desarrollo en Economía de la Empresa, FESIDE, 5U01AI042170-10, 5U01AI046362-03, FIPSE 3171/ 00 Funding details: Beijing Innovation Center for Future Chip, ICFC Funding details: INCLIVA Instituto de Investigación Sanitaria, FIS 99/0887 Funding text 1: The D:A:D study was supported by a grant (grant number DNRF126) from the Danish National Research Foundation (CHIP & PERSIMUNE) and by the Highly Active Antiretro-viral Therapy Oversight Committee (HAARTOC), 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 pharmaceutical companies with licensed anti-HIV drugs in the European Union: AbbVie, Bristol-Myers Squibb, Gilead Sciences Inc., ViiV Healthcare, Merck & Co Inc. and Jans-sen Pharmaceuticals. Supported also by a grant from the Dutch Ministry of Health, Welfare and Sport through the Center for Infectious Disease Control of the National Institute for Public Health and the Environment to Stiching HIV Monitoring (ATHENA) and by a grant from the Agence nationale de recherches sur le sida et les hépatites virales (ANRS; Action Coordonnée 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’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, Janssen-Cilag and ViiV Healthcare. 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 also by grants from the Fondo de Investigación Sanitaria (grant number FIS 99/0887) and Fundación para la Investigación y la Pre-vención del SIDA en Espanã (grant number FIPSE 3171/ 00) to the Barcelona Antiretroviral Surveillance Study (BASS); by grants from the National Institute of Allergy and Infectious Diseases, National Institutes of Health (grants number 5U01AI042170-10 and 5U01AI046362-03) to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA); by primary funding provided by the European Union’s Seventh Framework Programme for research, technological development and demonstration under EuroCoord grant agreement no 260694 and by unrestricted grants from Bristol-Myers Squibb, Janssen R&D, Merck and Co. Inc., Pfizer Inc. and GlaxoSmithKline LLC [the participation of centres from Switzerland was supported by The Swiss National Science Foundation (grant 108787)] to the EuroSIDA study; by unrestricted educational grants from AbbVie, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer and Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretro-virals (The ICONA Foundation); and was financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #148522) and by the SHCS Research Foundation. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. Funding text 2: The D:A:D study was supported by a grant (grant number DNRF126) from the Danish National Research Foundation (CHIP & PERSIMUNE) and by the Highly Active Antiretroviral Therapy Oversight Committee (HAARTOC), 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 pharmaceutical companies with licensed anti-HIV drugs in the European Union: AbbVie, Bristol-Myers Squibb, Gilead Sciences Inc., ViiV Healthcare, Merck & Co Inc. and Janssen Pharmaceuticals. Supported also by a grant from the Dutch Ministry of Health, Welfare and Sport through the Center for Infectious Disease Control of the National Institute for Public Health and the Environment to Stiching HIV Monitoring (ATHENA) and by a grant from the Agence nationale de recherches sur le sida et les h?patites virales (ANRS; Action Coordonn?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'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, Janssen-Cilag and ViiV Healthcare. 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 also by grants from the Fondo de Investigaci?n Sanitaria (grant number FIS 99/0887) and Fundaci?n para la Investigaci?n y la Prevenci?n del SIDA en Espan? (grant number FIPSE 3171/00) to the Barcelona Antiretroviral Surveillance Study (BASS); by grants from the National Institute of Allergy and Infectious Diseases, National Institutes of Health (grants number 5U01AI042170-10 and 5U01AI046362-03) to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA); by primary funding provided by the European Union's Seventh Framework Programme for research, technological development and demonstration under EuroCoord grant agreement no 260694 and by unrestricted grants from Bristol-Myers Squibb, Janssen R&D, Merck and Co. Inc., Pfizer Inc. and GlaxoSmithKline LLC [the participation of centres from Switzerland was supported by The Swiss National Science Foundation (grant 108787)] to the EuroSIDA study; by unrestricted educational grants from, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer and Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretrovirals (The ICONA Foundation); and was financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #148522) and by the SHCS Research Foundation. Funding text 3: Conflicts of interest: ADM has received grants for serving on advisory boards or lectures from Abbve, BMS, Gilead, Janssen, MSD and ViiV. PR has through his institution received independent scientific grant support from Gilead Sciences, Janssen Pharmaceuticals Inc., Merck & Co, Bristol-Myers Squibb and ViiV Healthcare; he has served on a scientific advisory board for Gilead Sciences and a data safety monitoring committee for Janssen Pharmaceuticals Inc.; he chaired a scientific symposium by ViiV Healthcare, for which his institution has received remuneration. AP received speaker’s fees for talks at two meetings sponsored by Gilead in 2015. ML has received unrestricted grants from Boehringer Ingelhiem, Gilead Sciences, Merck Sharp & Dohme, Bristol-Myers Squibb, Janssen-Cilag and ViiV HealthCare, consultancy payments from Gilead Sciences DSMB and sitting fees from Sirtex Pty Ltd. CS has received honoraria for membership of Data Safety and Monitoring Boards, Advisory Boards and Speaker Panels from Gilead Sciences, ViiV Healthcare and Janssen-Cilag. She has received funding to support the development of educational materials from Gilead Sciences and ViiV Healthcare. CIH, LR, WE-S, RW, OK, FD, EF, SdW and JL have no disclosures to declare. Funding text 4: Funding: grant number DNRF126 from the Danish National Research Foundation (CHIP & PERSIMUNE); Oversight Committee for the Evaluation of Metabolic Complications of HAART with representatives from academia, the patient community, FDA, EMA and a consortium of AbbVie, Bristol-Myers Squibb, Gilead Sciences, ViiV Healthcare, Merck and Janssen Pharmaceuticals. 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PY - 2018/10
Y1 - 2018/10
N2 - Objectives: Previous studies have suggested that hypertension in HIV-positive individuals is associated primarily with traditional risk factors such as older age, diabetes and dyslipidaemia. However, controversy remains as to whether exposure to antiretroviral (ARV) drugs poses additional risk, and we investigated this question in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort. Methods: The incidence of hypertension [systolic blood pressure (BP) > 140 and/or diastolic BP > 90 mmHg and/or initiation of antihypertensive treatment] was determined overall and in strata defined by demographic, metabolic and HIV-related factors, including cumulative exposure to each individual ARV drug. Predictors of hypertension were identified using uni- and multivariable Poisson regression models. Results: Of 33 278 included persons, 7636 (22.9%) developed hypertension over 223 149 person-years (PY) [incidence rate: 3.42 (95% confidence interval (CI) 3.35–3.50) per 100 PY]. In univariable analyses, cumulative exposure to most ARV drugs was associated with an increased risk of hypertension. After adjustment for demographic, metabolic and HIV-related factors, only associations for nevirapine [rate ratio 1.07 (95% CI: 1.04–1.13) per 5 years] and indinavir/ritonavir [rate ratio 1.12 (95% CI: 1.04–1.20) per 5 years] remained statistically significant, although effects were small. The strongest independent predictors of hypertension were male gender, older age, black African ethnicity, diabetes, dyslipidaemia, use of lipid-lowering drugs, high body mass index (BMI), renal impairment and a low CD4 count. Conclusions: We did not find evidence for any strong independent association between exposure to any of the individual ARV drugs and the risk of hypertension. Findings provide reassurance that screening policies and preventative measures for hypertension in HIV-positive persons should follow algorithms used for the general population. © 2018 British HIV Association
AB - Objectives: Previous studies have suggested that hypertension in HIV-positive individuals is associated primarily with traditional risk factors such as older age, diabetes and dyslipidaemia. However, controversy remains as to whether exposure to antiretroviral (ARV) drugs poses additional risk, and we investigated this question in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort. Methods: The incidence of hypertension [systolic blood pressure (BP) > 140 and/or diastolic BP > 90 mmHg and/or initiation of antihypertensive treatment] was determined overall and in strata defined by demographic, metabolic and HIV-related factors, including cumulative exposure to each individual ARV drug. Predictors of hypertension were identified using uni- and multivariable Poisson regression models. Results: Of 33 278 included persons, 7636 (22.9%) developed hypertension over 223 149 person-years (PY) [incidence rate: 3.42 (95% confidence interval (CI) 3.35–3.50) per 100 PY]. In univariable analyses, cumulative exposure to most ARV drugs was associated with an increased risk of hypertension. After adjustment for demographic, metabolic and HIV-related factors, only associations for nevirapine [rate ratio 1.07 (95% CI: 1.04–1.13) per 5 years] and indinavir/ritonavir [rate ratio 1.12 (95% CI: 1.04–1.20) per 5 years] remained statistically significant, although effects were small. The strongest independent predictors of hypertension were male gender, older age, black African ethnicity, diabetes, dyslipidaemia, use of lipid-lowering drugs, high body mass index (BMI), renal impairment and a low CD4 count. Conclusions: We did not find evidence for any strong independent association between exposure to any of the individual ARV drugs and the risk of hypertension. Findings provide reassurance that screening policies and preventative measures for hypertension in HIV-positive persons should follow algorithms used for the general population. © 2018 British HIV Association
KW - antiretroviral therapy
KW - cardiovascular disease
KW - HIV
KW - hypertension
KW - abacavir
KW - anti human immunodeficiency virus agent
KW - antihypertensive agent
KW - atazanavir
KW - darunavir plus ritonavir
KW - efavirenz
KW - emtricitabine
KW - indinavir plus ritonavir
KW - lamivudine
KW - lopinavir plus ritonavir
KW - nelfinavir
KW - nevirapine
KW - nonnucleoside reverse transcriptase inhibitor
KW - proteinase inhibitor
KW - ritonavir
KW - RNA directed DNA polymerase inhibitor
KW - tenofovir
KW - adult
KW - antihypertensive therapy
KW - Article
KW - cohort analysis
KW - female
KW - human
KW - Human immunodeficiency virus infected patient
KW - Human immunodeficiency virus infection
KW - incidence
KW - major clinical study
KW - male
KW - middle aged
KW - observational study
KW - priority journal
KW - risk factor
KW - chemically induced
KW - clinical trial
KW - ethnology
KW - multicenter study
KW - regression analysis
KW - Adult
KW - Anti-HIV Agents
KW - Female
KW - HIV Infections
KW - Humans
KW - Hypertension
KW - Incidence
KW - Male
KW - Regression Analysis
KW - Risk Factors
UR - http://doi.wiley.com/10.1111/hiv.12639
U2 - 10.1111/hiv.12639
DO - 10.1111/hiv.12639
M3 - Article
SN - 1464-2662
VL - 19
SP - 605
EP - 618
JO - HIV Medicine
JF - HIV Medicine
IS - 9
ER -