Article Text
Abstract
Background There is evidence that antiretroviral therapy (ART) increases cardiovascular risk (CVR). There is controversy over the effect of abacavir (ABC) on CVR. The use of abacavir has been associated with a higher incidence of myocardial infarction in several cohort studies, but data from clinical trials are not conclusive.
Purpose To determinate the effect of exposure to ABC and exposure time (ET) to ABC in CVR of a HIV-infected cohort on ART from the northwest of Spain.
Materials and Methods Cross-sectional study including HIV patients on ART who were treated at our hospital between March-May 2012. We recorded demographics, ART history and CVR risk factors. CVR was estimated using the Framingham function calibrated for Spanish population (REGICOR). CVR categories were: low (<5%); intermediate (5–9%); high (10–14%); very-high (>15%). Three ABC exposure groups were defined: a) no abacavir exposure (No ABC); b) exposure to abacavir but not to indinavir (ABC); c) exposure to abacavir and indinavir (ABC + IND).
Results 89 HIV patients were included in the study (83.1% males, mean age 47.4 ± 7.8 years). Smoking prevalence was 51.7%, hypertension 39.3%, dyslipidaemia 24.7%, low HDL cholesterol 67.4%, diabetes 4.5%. Mean global CVR was 4.01%±2.50. Proportion of patients with low CVR was 70.8%; intermediate 25.8%; high 2.2%; very high 1.1%. According to ABC exposure: mean CVR was 4.02 ± 2.62 (No ABC); 3.77 ± 2.28 (ABC); 4.30 ± 2.0 (ABC+IND). No significant differences were found when we compared mean risks of each group. We did not find differences in CVR according to ET to ABC.
Conclusions Apparently, ABC exposure does not increase CVR in our HIV-infected population. More prospective controlled studies are needed to evaluate any association between ABC and increased CVR.
No conflict of interest.