HAART and the heart: changes in coronary risk factors and implications for coronary risk in men starting antiretroviral therapy
Détails
ID Serval
serval:BIB_1BC46F397FFC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
HAART and the heart: changes in coronary risk factors and implications for coronary risk in men starting antiretroviral therapy
Périodique
Journal of Internal Medicine
ISSN
0954-6820 (Print)
Statut éditorial
Publié
Date de publication
03/2007
Volume
261
Numéro
3
Pages
255-67
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Mar
Research Support, Non-U.S. Gov't --- Old month value: Mar
Résumé
OBJECTIVES: To estimate changes in coronary risk factors and their implications for coronary heart disease (CHD) rates in men starting highly active antiretroviral therapy (HAART). METHODS: Men participating in the Swiss HIV Cohort Study with measurements of coronary risk factors both before and up to 3 years after starting HAART were identified. Fractional polynomial regression was used to graph associations between risk factors and time on HAART. Mean risk factor changes associated with starting HAART were estimated using multilevel models. A prognostic model was used to predict corresponding CHD rate ratios. RESULTS: Of 556 eligible men, 259 (47%) started a nonnucleoside reverse transcriptase inhibitor (NNRTI) and 297 a protease inhibitor (PI) based regimen. Levels of most risk factors increased sharply during the first 3 months on HAART, then more slowly. Increases were greater with PI- than NNRTI-based HAART for total cholesterol (1.18 vs. 0.98 mmol L(-1)), systolic blood pressure (3.6 vs. 0 mmHg) and BMI (1.04 vs. 0.55 kg m(2)) but not HDL cholesterol (0.24 vs. 0.32 mmol L(-1)) or glucose (1.02 vs. 1.03 mmol L(-1)). Predicted CHD rate ratios were 1.40 (95% CI 1.13-1.75) and 1.17 (0.95-1.47) for PI- and NNRTI-based HAART respectively. CONCLUSIONS: Coronary heart disease rates will increase in a majority of patients starting HAART: however the increases corresponding to typical changes in risk factors are relatively modest and could be offset by lifestyle changes.
Mots-clé
Adult
Aged
Anti-HIV Agents/*adverse effects
Antiretroviral Therapy, Highly Active/*adverse effects
Cohort Studies
Coronary Disease/*chemically induced
HIV Infections/complications/*drug therapy
Humans
Male
Middle Aged
Multivariate Analysis
Risk Factors
Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/01/2008 21:44
Dernière modification de la notice
20/08/2019 13:52