No accelerated progression of subclinical atherosclerosis with integrase strand transfer inhibitors compared to non-nucleoside reverse transcriptase inhibitors
2024

No increased risk of heart disease with integrase inhibitors in HIV patients

Sample size: 190 publication 10 minutes Evidence: moderate

Author Information

Author(s): García-Abellán Javier, García José A, Padilla Sergio, Fernández-González Marta, Agulló Vanesa, Mascarell Paula, Botella Ángela, Gutiérrez Félix, Masiá Mar

Primary Institution: Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Alicante, Spain

Hypothesis

Does the use of integrase strand transfer inhibitors (INSTI) lead to increased progression of subclinical atherosclerosis compared to non-nucleoside reverse transcriptase inhibitors (NNRTI) in people with HIV?

Conclusion

INSTI-based regimens are not associated with increased progression of subclinical atherosclerosis when compared to NNRTI.

Supporting Evidence

  • 190 participants were recruited and 173 completed the 96 week follow-up.
  • 87 participants experienced a cIMT increase ≥ 10%, with 54 developing a new carotid plaque.
  • Adjusted analyses showed no significant differences in cIMT progression between treatment groups.

Takeaway

This study looked at people with HIV taking different medications and found that those on integrase inhibitors didn't have more heart problems than those on other medications.

Methodology

A prospective study measuring carotid intima-media thickness (cIMT) in HIV patients on INSTI or NNRTI regimens over 96 weeks.

Potential Biases

Participants receiving both INSTI and NNRTI may have influenced the results.

Limitations

The study was non-randomized and had a relatively small sample size.

Participant Demographics

Median age was 48 years, with 81.1% male and 59% having at least one cardiovascular risk factor.

Statistical Information

P-Value

0.647

Confidence Interval

−0.031 to 0.103

Statistical Significance

p=0.647

Digital Object Identifier (DOI)

10.1093/jac/dkae383

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