Document Detail


Macrolide use and the risk of vascular disease in HIV-infected men in the Multicenter AIDS Cohort Study.
MedLine Citation:
PMID:  17524289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There has been increasing concern that HIV-infected individuals may be more at risk for cardiovascular events in the highly-active antiretroviral therapy (HAART) era. This study examined the risk of thromboembolic events in HIV-infected and non-infected individuals and the effect of macrolide prophylaxis on those outcomes. METHODS: A subcohort analysis was undertaken using data collected in the Multicenter AIDS Cohort Study to examine the relative risk of vascular events (myocardial infarction, unstable angina and ischaemic stroke). Cox proportional hazard model using age as the time scale with time varying cofactors obtained at each semi-annual visit were used to assess the independent effect of macrolide use. RESULTS: Controlling for other significant effects including race and smoking, HIV-infection was not independently associated with vascular events. Increased risk was observed among those who used HAART (relative hazard 1.09, 95% confidence intervals 1.00-1.19 in multivariate model), antihypertensive treatment (1.81 [1.26-2.60]), lipid-lowering medication (1.65 [1.12-2.42]), and antibiotics (1.72 [1.25-2.36]). The protective association of macrolide use for a vascular event in the HAART era was also significant (0.10 [0.01-0.75]). CONCLUSIONS: Traditional risk factors are important in the pathogenesis of vascular events in HIV-infected individuals. Macrolide antibiotics may have a protective effect in the HIV-infected individuals in the HAART era.
Authors:
Ian J Woolley; Xiuhong Li; Lisa P Jacobson; Frank J Palella; Lars Ostergaard
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Sexual health     Volume:  4     ISSN:  1448-5028     ISO Abbreviation:  -     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-25     Completed Date:  2007-09-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101242667     Medline TA:  Sex Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  111-9     Citation Subset:  IM    
Affiliation:
Infectious Diseases Department, Alfred Hospital, Monash University Medical School, Prahran 3004, Victoria, Australia. Ian.Woolley@med.monash.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina, Unstable / chemically induced,  prevention & control
Anti-HIV Agents / administration & dosage,  adverse effects*
Antiretroviral Therapy, Highly Active / adverse effects*
Cohort Studies
Coronary Thrombosis / chemically induced,  prevention & control
HIV Infections / drug therapy*
Humans
Macrolides / therapeutic use*
Male
Middle Aged
Myocardial Infarction / chemically induced
Proportional Hazards Models
Risk Factors
Stroke / chemically induced,  prevention & control
Vascular Diseases / chemically induced*,  prevention & control*
Grant Support
ID/Acronym/Agency:
5-M01-RR-00722/RR/NCRR NIH HHS; UO1-AI-35039/AI/NIAID NIH HHS; UO1-AI-35040/AI/NIAID NIH HHS; UO1-AI-35041/AI/NIAID NIH HHS; UO1-AI-35042/AI/NIAID NIH HHS; UO1-AI-35043/AI/NIAID NIH HHS; UO1-AI-37613/AI/NIAID NIH HHS; UO1-AI-37984/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Macrolides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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