Klein D, Hurley L, Sidney S; Conference on Retroviruses and Opportunistic Infections.

7th Conf Retrovir Oppor Infect Jan 30 Feb 2 2000 Conf Retrovir Oppor Infect 7th 2000 San Franc Calif. 2000 Jan 30-Feb 2; 7: 81 (abstract no. 33).

Kaiser Permanente Med. Care Program, Hayward, CA.

Background: Concern has been raised over increased risk of coronary heart disease (CHD) in patients receiving protease inhibitor (PI) therapy, perhaps consequent to higher lipid levels in patients on PIs and/or a direct thrombogenic effect of these drugs. Methods: Kaiser Permanente Northern California (KPNC), a not-for-profit HMO, cares for 2.8 million members. HIV positive (+) Health Plan (HP) members were followed in the period 1/1/96 to 6/30/99 and hospital events for CHD (ICD9 codes 410-414, primary discharge diagnosis) among the HIV+ cohort were identified. Patients with CHD events prior to the start of follow-up were excluded. Follow-up started 1/1/96 or at HIV diagnosis (whichever came later) and continued through the earliest of HP termination, death, or end of observation (6/30/99). Person-time was assigned to two categories: non-PI follow-up - days of follow-up which preceded any PI use; or PI follow-up - days of follow-up following the first use of a PI, if any. Patients could contribute time to both non-PI and PI follow-up. Age-adjusted (1990 census) incidence rates and confidence intervals (CI) were calculated overall and separately for non-PI and PI follow-up. CHD risk factors were assessed among members with events. Results: Overall, 4526 HIV patients contributed a mean of 2.6 person-years of follow-up and experienced 42 CHD events, representing an increase of 2500 person-years and 15 new events over what has been previously reported. 4518 patients contributed a mean of 1.4 person-years of non-PI follow-up and had 20 CHD events. 2661 patients contributed a mean of 2.0 person-years of PI follow-up and had 22 CHD events. Age-adjusted CHD hospitalization rates per 1000 person-years and 95% CIs were 5.6 (3.5, 7.6) overall, 5.5 (2.5, 8.4) for non-PI follow-up and 5.7 (2.8, 8.5) for PI follow-up. Multiple risk factors for CHD were present in our patients: hypertension (59%), hypercholesteremia (54%), diabetes mellitus (15%) and current smoker (41%). Conclusion: In our ongoing study, our data continue to suggest that PI use does not increase short-term risk for CHD. As in all patients with multiple risk factors for CHD, risk reduction management is warranted.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• California
• Coronary Disease
• Diabetes Mellitus
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• Humans
• Hypertension
• Incidence
• Protease Inhibitors
• Risk Factors

Other ID:

• GWAIDS0005415

UI: 102242912

From Meeting Abstracts