Document Detail

Atazanavir is not associated with an increased risk of cardio or cerebrovascular disease events.
MedLine Citation:
PMID:  23291539     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: To investigate whether there is any association between exposure to atazanavir (ATV), either when boosted or unboosted by ritonavir, and myocardial infarction (MI) or stroke within the D:A:D: Study. DESIGN:: Prospective cohort collaboration. METHODS:: Poisson regression was used to investigate the association between cumulative exposure to ATV and MI/stroke risk after adjusting for known demographic and clinical confounders, as well as cumulative and recent exposure to specific antiretroviral drugs. Follow-up started on enrolment in the study and ended at the earliest of: a new MI/stroke event, death, 6 months after last clinic visit, or 1 February 2011. RESULTS:: The incidence of MI varied from 0.28 [95% confidence interval (CI) 0.26-0.30)]/100 person-years of follow-up (PYFU) in those with no exposure to ATV to 0.20 (0.12-0.32)/100 PYFU in those with more than 3 years exposure. There was no evidence of an association between cumulative exposure to ATV and MI risk, either in univariate [relative rate/year 0.96 (95% CI 0.88-1.04)] or multivariable [0.95 (0.87-1.05)] analyses. The incidence of stroke was 0.17 (0.16-0.19)/100 PYFU in those with no exposure to ATV and 0.17 (0.10-0.27)/100 PYFU in those with more than 3 years exposure. As with the MI endpoint, there was no evidence of an association with ATV exposure in either univariate [1.02 (0.98-1.05)] or multivariable [0.95 (0.87-1.05)] analyses. CONCLUSION:: These results argue against a class-wide association between exposure to HIV protease inhibitors and the risk of cardio/cerebrovascular events.
Antonella d'Arminio Monforte; Peter Reiss; Lene Ryom; Wafaa El-Sadr; Francois Dabis; Stephane De Wit; Signe W Worm; Mathew G Law; Rainer Weber; Ole Kirk; Christian Pradier; Andrew N Phillips; Jens D Lundgren; Caroline A Sabin
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Publication Detail:
Journal Detail:
Title:  AIDS (London, England)     Volume:  27     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  -    
Other Details:
Languages:  ENG     Pagination:  407-415     Citation Subset:  -    
aHospital San Paolo, University of Milan, Italy bAcademic Medical Center, Amsterdam, The Netherlands cCopenhagen HIV Programme, University of Copenhagen, Copenhagen, Denmark dColumbia University/Harlem Hospital, New York, USA eINSERM, Centre INSERM U897 'Epidémiologie et Biostatistique' fUniversité Bordeaux Segalen, Institut de Santé Publique Epidémiologie Développement (ISPED), Bordeaux, France gCHU Saint-Pierre Hospital, Department of Infectious Diseases, Brussels, Belgium hKirby Institute, University of New South Wales, Sydney, Australia iDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland jCHU Nice Hopital de l'Archet, Nice, France kResearch Department of Infection and Population Health, UCL, London, UK.
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