Recent abacavir use and incident cardiovascular disease in contemporary treated people living with HIV. AIDS
Jaschinski et al. analyzed the relationship between abacavir (ABC) use and the development of cardiovascular disease (CVD) events among participants of RESPOND, a large collaboration of HIV cohorts from Europe and Australia.
All individuals with follow-up after 2012 were included. CVD events included a composite of myocardial infarction, stroke, or invasive cardiovascular procedures. The association between recent ABC use (within the last 6 months) and CVD events were evaluated using negative binomial regression models, adjusted for clinical and HIV-specific confounders.
The study included 29’340 individuals, of whom 74% were men, 43% were of Western European origin, 45% were MSM, and the median age was 44 years (interquartile range 36-51). Within 6.2 years of follow-up (3.9-7.5), 748 CVD events occurred: 299 myocardial infarctions, 228 strokes, and 221 invasive cardiovascular procedures. After adjusting for confounders, the incidence rate ratio (IRR) for developing CVD events was higher for individuals with recent ABC use compared to those who did not receive ABC (adjusted IRR 1.40, 95% CI 1.20-1.64).
In summary, the present study found a 40% CVD risk increase for individuals who receive ABC as part of their antiretroviral therapy. These results confirm previous findings from the D:A:D cohort, and add to the body of evidence of CVD-related adverse effects of ABC.