Dataset Information

Association of Incomplete Adherence to Antiretroviral Therapy With Cardiovascular Events and Mortality in Virologically Suppressed Persons With HIV: The Swiss HIV Cohort Study.

ABSTRACT:

Background

Incomplete antiretroviral therapy (ART) adherence, even if sufficient to maintain viral suppression, is associated with enhanced inflammation in persons with HIV (PWH). However, its clinical implications remain unknown.

Methods

PWH enrolled in the Swiss HIV Cohort Study without a history of cardiovascular disease (CVD) who initiated ART between 2003 and 2018 and had viral suppression (<50 copies/mL) for ?6 months were evaluated. The association between incomplete self-reported ART adherence (?1 or ?2 missed doses in the last month) and (1) any CVD event (myocardial infarction, revascularization, cerebral hemorrhage, stroke, and/or death due to CVD event) or (2) non-CVD-related death was evaluated using adjusted Cox proportional hazards models.

Results

A total of 6971 PWH (74% male) were included in the analysis (median age [interquartile range {IQR}], 39 [32-47] years). The median (IQR) follow-up was 8 (4-11) years, with 14 (8-23) adherence questionnaires collected per participant. In total, 205 (3%) participants experienced a CVD event, and 186 (3%) died a non-CVD-related death. In an adjusted competing risk model where missing data were imputed, missing ?1 ART dose showed an increased, but not statistically significant, risk for CVD events (hazard ratio [HR], 1.23; 95% CI, 0.85-1.79; P?=?.28). Non-CVD-related mortality showed a statistically significantly increased risk with missing ?1 ART dose (HR, 1.44; 95% CI, 1.00-2.07; P?=?.05) and missing ?2 ART doses (HR, 2.21; 95% CI, 1.37-3.57; P?=?.001).

Conclusions

Incomplete ART adherence was significantly associated with an increased risk for non-CVD-related mortality in PWH with virologic suppression. This highlights the potential role of nonadherence to ART as a driver of non-AIDS clinical outcomes.

SUBMITTER: Castillo-Mancilla JR

PROVIDER: S-EPMC7880264 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Association of Incomplete Adherence to Antiretroviral Therapy With Cardiovascular Events and Mortality in Virologically Suppressed Persons With HIV: The Swiss HIV Cohort Study.

Castillo-Mancilla Jose R JR Cavassini Matthias M Schneider Marie Paule MP Furrer Hansjakob H Calmy Alexandra A Battegay Manuel M Scanferla Giulia G Bernasconi Enos E Günthard Huldrych F HF Glass Tracy R TR

Open forum infectious diseases 20210121 2

<h4>Background</h4>Incomplete antiretroviral therapy (ART) adherence, even if sufficient to maintain viral suppression, is associated with enhanced inflammation in persons with HIV (PWH). However, its clinical implications remain unknown.<h4>Methods</h4>PWH enrolled in the Swiss HIV Cohort Study without a history of cardiovascular disease (CVD) who initiated ART between 2003 and 2018 and had viral suppression (<50 copies/mL) for ≥6 months were evaluated. The association between incomplete self-r ...[more]

PMID: 33604408

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Dataset Information

Association of Incomplete Adherence to Antiretroviral Therapy With Cardiovascular Events and Mortality in Virologically Suppressed Persons With HIV: The Swiss HIV Cohort Study.

Background

Methods

Results

Conclusions

Publications

Association of Incomplete Adherence to Antiretroviral Therapy With Cardiovascular Events and Mortality in Virologically Suppressed Persons With HIV: The Swiss HIV Cohort Study.

Similar Datasets

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