Hierarchical modeling gave plausible estimates of associations between metabolic syndrome and components of antiretroviral therapy.

Détails

ID Serval
serval:BIB_DADAFC5F4F9A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Hierarchical modeling gave plausible estimates of associations between metabolic syndrome and components of antiretroviral therapy.
Périodique
Journal of Clinical Epidemiology
Auteur(s)
Young J., Glass T.R., Bernasconi E., Rickenbach M., Furrer H., Hirschel B., Tarr P.E., Vernazza P., Battegay M., Bucher H.C.
Collaborateur(s)
Swiss HIV Cohort Study
Contributeur(s)
Battegay M., Bernasconi E., Böni J., Bucher HC., Bürgisser P., Cattacin S., Cavassini M., Dubs R., Egger M., Elzi L., Erb P., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Gorgievski M., Günthard H., Hirsch H., Hirschel B., Hösli I., Kahlert Ch., Kaiser L., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Opravil M., Paccaud F., Pantaleo G., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
1878-5921 (Electronic)
ISSN-L
0895-4356
Statut éditorial
Publié
Date de publication
2009
Volume
62
Numéro
6
Pages
632-641
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
OBJECTIVE: Hierarchical modeling has been proposed as a solution to the multiple exposure problem. We estimate associations between metabolic syndrome and different components of antiretroviral therapy using both conventional and hierarchical models.
STUDY DESIGN AND SETTING: We use discrete time survival analysis to estimate the association between metabolic syndrome and cumulative exposure to 16 antiretrovirals from four drug classes. We fit a hierarchical model where the drug class provides a prior model of the association between metabolic syndrome and exposure to each antiretroviral.
RESULTS: One thousand two hundred and eighteen patients were followed for a median of 27 months, with 242 cases of metabolic syndrome (20%) at a rate of 7.5 cases per 100 patient years. Metabolic syndrome was more likely to develop in patients exposed to stavudine, but was less likely to develop in those exposed to atazanavir. The estimate for exposure to atazanavir increased from hazard ratio of 0.06 per 6 months' use in the conventional model to 0.37 in the hierarchical model (or from 0.57 to 0.81 when using spline-based covariate adjustment).
CONCLUSION: These results are consistent with trials that show the disadvantage of stavudine and advantage of atazanavir relative to other drugs in their respective classes. The hierarchical model gave more plausible results than the equivalent conventional model.
Mots-clé
Adult, Anti-HIV Agents/adverse effects, Anti-Retroviral Agents/adverse effects, Antiretroviral Therapy, Highly Active/adverse effects, Female, HIV Infections/complications, HIV Infections/drug therapy, HIV Protease Inhibitors/adverse effects, Humans, Male, Metabolic Syndrome X/chemically induced, Models, Statistical, Oligopeptides/adverse effects, Prospective Studies, Pyridines/adverse effects, Reverse Transcriptase Inhibitors/adverse effects, Risk Factors, Stavudine/adverse effects, Switzerland
Pubmed
Web of science
Création de la notice
26/02/2009 11:21
Dernière modification de la notice
03/03/2018 21:55
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