No accelerated progression of subclinical atherosclerosis with integrase strand transfer inhibitors compared to non-nucleoside reverse transcriptase inhibitors
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The role of integrase strand transfer inhibitors (INSTI) in the cardiovascular risk of people with HIV is controversial. OBJECTIVES: To assess the association of INSTI to subclinical atherosclerosis progression measured with the carotid intima-media thickness (cIMT). METHODS: Prospective study in virologically suppressed people with HIV receiving INSTI- or NNRTI-based regimens. cIMT was measured at baseline, 48 and 96 weeks. cIMT progression was analysed both as a continuous and categorical variable, defined as cIMT increase ≥ 10% and/or new carotid plaque. Adjustments through Cox proportional hazard regression and linear mixed models, and propensity score matching were conducted. RESULTS: 190 participants were recruited and 173 completed the 96 week follow-up. 107 (56.3%) were receiving an INSTI-containing, 128 (67.4%) a NNRTI-containing and 45 (23.7%) a NNRTI plus an INSTI-containing regimen. The overall median (IQR) 2-year change of cIMT was 0.029 (-0.041 to 0.124) mm; 87 (45.8%) participants experienced a cIMT increase ≥ 10%, of whom 54 (28.4%) developed a new carotid plaque. Adjusted Cox regression showed no differences between INSTI and NNRTI groups in the categorical 2-year progression of cIMT, both including or excluding participants receiving INSTI + NNRTI. Similar results were observed for the continuous cIMT increase through adjusted linear mixed models. Propensity score matching showed no significant differences in the 2 year cIMT change between treatment groups [0.049 mm (-0.031-0.103) in the INSTI group versus 0.047 mm (-0.023-0.115) in the NNRTI group; P = 0.647]. cIMT progression was associated with traditional cardiovascular risk factors. CONCLUSIONS: INSTI-based regimens are not associated with increased progression of subclinical atherosclerosis when compared to NNRTI.
DOI: 10.1093/jac/dkae383
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,851
Funders: Generalitat Valenciana, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Instituto de Salud Carlos III, European Regional Development Fund, Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana, Spanish National Plan for Scientific and Technical Research and Innovation, FP7 Science in Society
Awards: G1075404386, G1129913611, G1157557275, G1401781507, G1908114364, G3385130310, G3566304949, IMpacto de un Programa Ampliado de Cribado en la detección de NEOplasias no-sida en pacientes con infección por el Virus de la Inmunodeficiencia Humana (VIH). IMPAC-NEO., G5323405848, G5324351655, G5581592847, G5717756140, G5973149249, Influencia de la composición del microbioma intestinal en la progresión de la arteriosclerosis en pacientes con infección por el VIH en tratamiento antirretroviral eficaz, G7796186901, G8153779787, G8445392327, Factores inmunológicos, bacteriológicos y virológicos potencialmente implicados en la recurrencia de displasia anal de alto grado en personas con VIH
OpenAlex ID: W4403749553