Abacavir ART Does Not Increase Risk for Myocardial Infarction or CVD

STEMI heart attack_TS_459277671
STEMI heart attack_TS_459277671
Abacavir-containing antiretroviral therapy does not appear to confer an increased risk for myocardial infarction or coronary artery disease.
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SAN DIEGO — Patients who receive abacavir-containing antiretroviral therapy (ART) for HIV do not have an increased risk for myocardial infarction (MI) or coronary artery disease (CAD), according to data presented at IDWeek 2017.

Researchers conducted a meta-analysis of 66 clinical trials that focused on the incidence rates (IR) and relative rates (RR) of MI and CAD in patients who were randomly assigned to abacavir-containing ART or other ART or who were prescribed abacavir as background therapy. Shorter duration and nonrandomized trials were included in secondary analyses.

A total of 13,119 patients received abacavir-containing ART and 7350 did not. In patients who received abacavir-containing ART, the MI exposure-adjusted IR was 1.5 per 1000 person-years (95% CI, 0.67-3.34) vs 2.18 per 1000 person-years (95% CI, 1.09-4.40) in patients who were not exposed to abacavir-containing ART, with an RR of 0.69 (95% CI, 0.24-1.98). The RR for MI was 0.69 (95% CI, 0.24-1.99) when studies of a shorter duration were included and 0.83 (95% CI, 0.44-1.60) when nonrandomized trials were included.

Meanwhile, the IR for CAD in those exposed to abacavir-containing ART was 2.9 per 1000 person-years (95% CI, 2.09-4.02) vs 4.69 per 1000 person-years (95% CI, 3.4-6.47) in patients who were not exposed, specifically related to studies with at least 48 weeks of follow-up. With studies that had fewer than 48 weeks of follow-up, the IR for CAD in patients exposed to abacavir was 2.96 per 1000 person-years (95% CI, 2.14-4.08) and 4.6 per 1000 person-years (95% CI, 3.37-6.42) in those who were not exposed to abacavir, with an RR of 0.64 (95% CI, 0.4-1.0).

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“These findings provide further evidence against an association between MI and CAD and [abacavir] exposure in this clinical trial population,” the researchers concluded. “Modifiable risk factors for MI and CAD should be addressed when prescribing ART for treatment of HIV.”

Disclosures: Several researchers are employees of GlaxoSmithKline and ViiV Healthcare.For a detailed list, please see the complete abstract

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Nan C, Shaefer MS, Urbaityte R, et al. Abacavir use and risk for myocardial infarction and coronary artery disease: updated meta-analysis of data from clinical trials. Presented at: ID Week 2017; San Diego, CA; October 4-8, 2017. Abstract 575.