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

Friis-Møller, Nina; Ryom, Lene; Smith, Colette; Weber, Rainer; Reiss, Peter; Dabis, François; Wit, Stéphane De; Monforte, Antonella d’Arminio; Kirk, Ole; Fontas, Éric; Sabin, Caroline; Phillips, Andrew; Lundgren, Jens D; Law, Matthew

doi:10.1177/2047487315579291

Cited by 184 publications

(212 citation statements)

References 29 publications

(24 reference statements)

Supporting

Mentioning

194

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, these previous data also supported a strong association between CVD and renal function, which significantly diminished after accounting for other risk factors, suggesting an underlying biological mechanism at least partly mediated by other factors. We have also previously showed an association between the use of certain antiretroviral drugs and CVD and renal impairment [28,30,32]. The results of this analysis are entirely consistent with these prior findings, and adjustment for the use of individual antiretroviral drugs did not have any major impact on the association between impaired eGFR and CVD.…”

Section: Discussionsupporting

confidence: 81%

“…This methodology may explain why more severe levels of renal impairment are necessary to establish an association with CVD. Interestingly, none of the widely accepted CVD risk prediction models currently include renal impairment in the estimates [30,32], but the proportion of individuals with advanced renal impairment may be too limited to date.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background. While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)-positive individuals.Methods. Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.Results. During a median follow-up duration of 8.0 years (interquartile range, 5.4-8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0-5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%-2.0%) with an eGFR > 90 mL/minute/1.73 m 2 estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%-35.6%) among those with an eGFR ≤ 30 mL/minute/1.73 m 2 . The strong univariate relationship between low current eGFR and CVD was primarily explained by increasing age in adjusted analyses, although all eGFRs ≤ 80 mL/minute/1.73 m 2 remained associated with 30%-40% increased CVD rates, and particularly high CVD rates among individuals with an eGFR ≤ 30 mL/minute/1.73 m 2 (incidence rate ratio, 3.08 [95% CI, 2.04-4.65]).Conclusions. Among HIV-positive individuals in a large contemporary cohort, a strong relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…La utilización de IP está asociada a dislipidemia, independientemente de la carga viral, recuento de linfocitos CD4 y sexo, e incluso de otros factores de riesgo cardiovascular como el tabaquismo (11) . Por tal motivo, el uso de IP ya se incluye como factor en algunas escalas de riesgo cardiovascular (14) .…”

Section: Discussionunclassified

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Taype‐Rondan

Flores-Flores

Doria

et al. 2017

Rev Peru Med Exp Salud Publica

View full text Add to dashboard Cite

RESUMENEl objetivo del estudio fue determinar la frecuencia y características de la dislipidemia en pacientes con VIH en terapia antirretroviral de gran actividad (TARGA) en un hospital público peruano. Se realizó un estudio transversal en pacientes que tuvieran un perfil lipídico completo luego de recibir al menos seis meses de TARGA. La dislipidemia se definió según los criterios NCEP-ATP III. Se revisaron 2975 historias clínicas, 538 (18.1%) fueron incluidas en el análisis. La frecuencia de dislipidemia fue 74.7%. Los esquemas de TARGA que incluían inhibidores de la proteasa (IP) (OR 1.22; IC95% 1,11-1,34) y la edad mayor de 40 años (OR 1.17; IC95% 1,06-1,29) mostraron asociación con dislipidemia, ajustado por carga viral, nivel de células CD4 y sexo. En conclusión, la dislipidemia fue muy frecuente en la muestra estudiada y estuvo asociada principalmente al uso de IP. Es necesario promover el control de la dislipidemia como parte de la atención integral del paciente con infección por VIH. Palabras clave: Dislipidemias; VIH; Terapia antirretroviral altamente activa (fuente: DeCS BIREME). HIGH FREQUENCY OF DYSLIPIDEMIA IN HIV-INFECTED PATIENTS IN A PERUVIAN PUBLIC HOSPITAL ABSTRACTThe objective of the study was to determine the frequency and characteristics of dyslipidemia in patients with HIV in highly active antiretroviral therapy (HAART) in a Peruvian public hospital. A cross-sectional study was carried out in patients with complete lipid profile after receiving at least six months of HAART. Dyslipidemia was defined according to the criteria of the NCEP-ATP III. We reviewed 2 975 clinical histories, and included 538 (18.1%) in the analysis. The frequency of dyslipidemia was 74.7%. HAART regimens which include protease inhibitors (PI) (odds ratio [OR]: 1.22; confidence interval at 95% [CI 95%]: 1.11-1.33) and to be older than 40 years (OR: 1.17; CI 95%: 1.05-1.28) were associated with dyslipidemia, adjusted by viral load, CD4 lymphocyte level and gender. In conclusion, dyslipidemia was very common in our sample and was mainly associated with the use of PI. It is necessary to promote the dyslipidemia control as part of the comprehensive care of the patient with HIV.

show abstract

“…There were no clinically meaningful differences in the total cholesterol to HDL cholesterol ratio, which is incorporated into cardiovascular clinical risk predictors for HIV‐infected and uninfected individuals 19, 20. Lipid differences of similar magnitude between TAF‐ and TDF‐treated participants have resulted in no differences in atherosclerotic cardiovascular disease (ASCVD) estimated cardiovascular risk, or eligibility for statins 21.…”

Section: Discussionmentioning

confidence: 99%

Switching to coformulated rilpivirine (RPV), emtricitabine (FTC) and tenofovir alafenamide from either RPV, FTC and tenofovir disoproxil fumarate (TDF) or efavirenz, FTC and TDF: 96‐week results from two randomized clinical trials

Hagins

Orkin

et al. 2018

HIV Medicine

View full text Add to dashboard Cite

ObjectivesThe single‐tablet regimen rilpivirine, emtricitabine and tenofovir alafenamide (RPV/FTC/TAF) for treatment of HIV‐1‐infected adults was approved based on bioequivalence. We assessed the clinical efficacy, safety and tolerability of switching to RPV/FTC/TAF from either RPV/FTC/tenofovir disoproxil fumarate (TDF) or efavirenz (EFV)/FTC/TDF.MethodsWe conducted two distinct randomized, double‐blind, active‐controlled, noninferiority trials in participants taking RPV/FTC/TDF (Study 1216) and EFV/FTC/TDF (Study 1160). Each study randomized virologically suppressed (HIV‐1 RNA < 50 copies/mL) adults (1:1) to switch to RPV/FTC/TAF or continue their current regimen for 96 weeks. We evaluated efficacy as the proportion with HIV‐1 RNA < 50 copies/mL using the Food and Drug Administration snapshot algorithm and prespecified bone and renal endpoints at week 96.ResultsWe randomized and treated 630 participants in Study 1216 (RPV/FTC/TAF, n = 316; RPV/FTC/TDF, n = 314) and 875 in Study 1160 (RPV/FTC/TAF, n = 438; EFV/FTC/TDF, n = 437). In both studies, the efficacy of switching to RPV/FTC/TAF was noninferior to that of continuing baseline therapy at week 96, with respective percentages of patients with HIV RNA < 50 copies/mL being 89.2% versus 88.5% in Study 1216 [difference 0.7%; 95% confidence interval (CI) −4.3 to +5.8%] and 85.2% versus 85.1% in Study 1160 (difference 0%; 95% CI −4.8 to +4.8%). No participant on RPV/FTC/TAF developed treatment‐emergent resistance versus two on EFV/FTC/TDF and one on RPV/FTC/TDF. Compared with continuing baseline therapy, significant improvements in bone mineral density and renal tubular markers were observed in the RPV/FTC/TAF groups (P < 0.001).ConclusionsSwitching to RPV/FTC/TAF from RPV/FTC/TDF or EFV/FTC/TDF was safe and effective and improved bone mineral density and renal biomarkers up to 96 weeks with no cases of treatment‐emergent resistance.

show abstract

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

Cited by 184 publications

References 29 publications

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Switching to coformulated rilpivirine (RPV), emtricitabine (FTC) and tenofovir alafenamide from either RPV, FTC and tenofovir disoproxil fumarate (TDF) or efavirenz, FTC and TDF: 96‐week results from two randomized clinical trials

Contact Info

Product

Resources

About