Abacavir linked to increased cardiovascular risk in HIV patients, study finds

Present or earlier use of the antiretroviral drug (ARV) abacavir was related to an elevated threat of main hostile cardiovascular occasions (MACE) in individuals with HIV, in keeping with an exploratory evaluation from a big worldwide medical trial primarily funded by the Nationwide Institutes of Well being (NIH). There was no elevated MACE threat for the opposite antiretroviral medicine included within the evaluation. The findings will probably be offered on the 2024 Worldwide AIDS Convention (AIDS 2024) in Munich, Germany.

The Randomized Trial to Forestall Vascular Occasions in HIV (REPRIEVE) enrolled 7,769 research contributors with HIV from 12 international locations that discovered every day use of a cholesterol-fighting statin drug diminished the chance of main hostile cardiovascular occasions, corresponding to coronary heart assaults and strokes by multiple third. The REPRIEVE research staff additionally carried out statistical analyses to evaluate whether or not choose ARVs had been related to MACE threat amongst research contributors, all of whom had low-to-moderate heart problems threat. The ARVs chosen for evaluation had beforehand been linked to cardiovascular threat and included abacavir, tenofovir, zidovudine, stavudine, and medicines from a category referred to as protease inhibitors (PIs). All had been taken as a part of multi-drug ART regimens.

Total, 22% of research contributors reported prior publicity to abacavir, 86% to tenofovir, 49% to zidovudine or stavudine, and 47% to PIs. At research entry, 13% of contributors had been taking abacavir, 61% had been taking tenofovir, 10% had been taking zidovudine or stavudine, and 26% had been taking PIs. Within the investigators’ analyses, contributors with prior and present use of abacavir had a 50% and 42% elevated threat of MACE, respectively, in comparison with contributors with no abacavir publicity. Former or present use of different ARVs was not related to any change in MACE threat, and the co-administration of frequent ARV drug courses as a part of an ART routine didn’t influence the elevated MACE threat amongst contributors with present or prior abacavir publicity. 

In keeping with the authors, these findings align with earlier research that additionally recognized an elevated heart problems threat related to abacavir. They recommend that extra analysis is required to raised perceive the elevated threat noticed on this evaluation, together with how these findings ought to be thought-about within the context of recognized heart problems threat elements, corresponding to dyslipidemia, diabetes and hypertension, for individuals with HIV.