A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men

May, Margaret; Sterne, Jonathan A C; Shipley, Martin; Brunner, Eric; d'Agostino, Ralph; Whincup, Peter; Ben-Shlomo, Yoav; Carr, Andrew; Ledergerber, Bruno; Lundgren, Jens D; Phillips, Andrew N; Massaro, Joseph; Egger, Matthias (2007). A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men. International journal of epidemiology, 36(6), pp. 1309-18. Oxford: Oxford University Press 10.1093/ije/dym135

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BACKGROUND: Many HIV-infected patients on highly active antiretroviral therapy (HAART) experience metabolic complications including dyslipidaemia and insulin resistance, which may increase their coronary heart disease (CHD) risk. We developed a prognostic model for CHD tailored to the changes in risk factors observed in patients starting HAART. METHODS: Data from five cohort studies (British Regional Heart Study, Caerphilly and Speedwell Studies, Framingham Offspring Study, Whitehall II) on 13,100 men aged 40-70 and 114,443 years of follow up were used. CHD was defined as myocardial infarction or death from CHD. Model fit was assessed using the Akaike Information Criterion; generalizability across cohorts was examined using internal-external cross-validation. RESULTS: A parametric model based on the Gompertz distribution generalized best. Variables included in the model were systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, triglyceride, glucose, diabetes mellitus, body mass index and smoking status. Compared with patients not on HAART, the estimated CHD hazard ratio (HR) for patients on HAART was 1.46 (95% CI 1.15-1.86) for moderate and 2.48 (95% CI 1.76-3.51) for severe metabolic complications. CONCLUSIONS: The change in the risk of CHD in HIV-infected men starting HAART can be estimated based on typical changes in risk factors, assuming that HRs estimated using data from non-infected men are applicable to HIV-infected men. Based on this model the risk of CHD is likely to increase, but increases may often be modest, and could be offset by lifestyle changes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Sterne, Jonathan and Egger, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0300-5771

ISBN:

17652317

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:52

Last Modified:

27 Oct 2019 15:48

Publisher DOI:

10.1093/ije/dym135

PubMed ID:

17652317

Web of Science ID:

000252247400028

BORIS DOI:

10.7892/boris.22099

URI:

https://boris.unibe.ch/id/eprint/22099 (FactScience: 30414)

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