期刊
AIDS
卷 27, 期 3, 页码 407-415出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e32835b2ef1
关键词
atazanavir; cardiovascular disease; cerebrovascular disease; HIV; myocardial infarction; stroke
资金
- Highly Active Antiretroviral Therapy Oversight Committee (HAART-OC)
- European Agency for the Evaluation of Medicinal Products
- United States Food and Drug Administration
- Abbott Laboratories
- Boehringer Ingelheim Pharmaceuticals Inc.
- Bristol-Myers Squibb
- Gilead Sciences Inc.
- Viiv Healthcare
- Merck Co Inc.
- Pfizer Inc
- F. Hoffman-LaRoche Ltd
- Janssen Pharmaceuticals
- Health Insurance Fund Council, Amstelveen, the Netherlands [CURE/97-46486]
- Agence Nationale de Recherches sur le SIDA
- U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID) [U01-AI069907]
- Merck Sharp Dohme
- Gilead Sciences
- Roche
- Pfizer
- GlaxoSmithKline
- The Australian Government Department of Health and Ageing
- Fondo de Investigacion Sanitaria [FIS 99/0887]
- Fundacion para la Investigacion y la Prevencion del SIDA en Espana [FIPSE 3171/00]
- National Institute of Allergy and Infectious Diseases, National Institutes of Health [5U01AI042170-10, 5U01AI046362-03]
- BIOMED 1 [CT94-1637]
- BIOMED 2 [CT97-2713]
- European Commission [QLK2-2000-00773]
- Pfizer Inc.
- Swiss National Science Foundation
- Gilead
- Boehringer Ingelheim
- Janssen-Cilag
- Abbott
- TRB Chemedica
- Tibotec
- Johnson Johnson
- GSK Bio
- Janssen
- Bristol-Myer Squibb
- Abbott Pharmaceuticals
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 anti-retroviral 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. (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2013, 27:407-415
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