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Hypertension Risk with Abacavir Use among HIV-Infected Individuals: A Nationwide Cohort Study

Jungmee Kim1, Ji Hwan Bang2, Ju Young Shin3

  • 1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.

Yonsei Medical Journal
|November 20, 2018
PubMed

Insights

Abacavir use in HIV patients does not increase hypertension risk overall. However, poor adherence, antibiotic use, male sex, and older age are associated with increased hypertension risk when using abacavir.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • HIV infection is linked to increased cardiovascular disease (CVD) risk.
  • Abacavir's association with hypertension is not well-established.
  • This study investigates hypertension risk in HIV patients using abacavir-based antiretroviral therapy (ART).

Purpose of the Study:

  • To evaluate the risk of hypertension associated with abacavir use.
  • To compare hypertension incidence between abacavir and non-abacavir ART regimens.
  • To identify subgroups at higher risk of hypertension with abacavir.

Main Methods:

  • Analysis of a nationwide cohort of 6493 HIV-infected individuals initiating ART.
  • Hypertension-free participants at baseline were followed from 2008-2016.
  • Cox proportional hazard models assessed hypertension risk (HRs) with time-varying ART exposure.

Main Results:

  • Hypertension incidence rates were 4.6 per 100 person-years for abacavir users vs. 3.6 for non-abacavir users.
  • Abacavir did not significantly increase overall hypertension risk (HR 1.2, p=0.061).
  • Increased risk observed with poor ART adherence (HR 1.9), prophylactic antibiotics (HR 1.2), male sex, age ≥40, and urban tertiary hospital visits.

Conclusions:

  • Abacavir is not associated with increased hypertension risk in the general HIV population.
  • Specific factors like poor ART adherence, antibiotic use, male sex, and older age increase hypertension risk in abacavir-treated patients.
  • These factors warrant careful monitoring for hypertension in patients on abacavir.
Abstract

Keywords:
HIVHypertensionabacavirantiretroviral therapyepidemiology

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