Abacavir Use Linked to Increased Incidence of MACE

THURSDAY, Aug. 8, 2024 (HealthDay News) — For patients with HIV in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) trial, use of abacavir was associated with an increased incidence of major adverse cardiovascular events (MACE), according to a study presented at AIDS 2024, the 25th International AIDS Conference, held from July 22 to 26 in Munich.

Carl J. Fichtenbaum, M.D., from the University of Cincinnati, and colleagues examined the role of prior and current use of antiretroviral agents (ART) on the development of MACE in a trial involving 7,769 participants aged 40 to 75 years on ART for at least 180 days.

The median duration of ART use was 9.5 years, with variation by country. The researchers found that 22, 86, 49, and 47 percent of participants reported prior exposure to abacavir, tenofovir (TDF), thymidine analogs (AZT/d4T), and protease inhibitors (PIs), respectively. At study entry, 13, 61, 10, and 26 percent were using abacavir, TDF, AZT/d4T, and PIs, respectively. Entry regimens included two nucleoside reverse transcriptase inhibitors (NRTIs) plus a non-NRTI, integrase strand transfer inhibitor, or PI (47, 25, and 19 percent, respectively). Both former and current use of abacavir was associated with a higher incidence of MACE in adjusted analyses including the baseline regimen. No association was seen for former or current use of other ART agents with MACE.

“Former and current use of abacavir was associated with a higher incidence of subsequent major adverse cardiovascular events in the REPRIEVE trial,” the authors write.

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