Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021
Current U.S. guidelines recommend integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) as initial treatment for people with HIV (PWH). We assessed long-term effects of INSTI use on lipid profiles in routine HIV care. We analyzed medical record data from the HIV Outpatient S...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2023/4423132 |
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| author | Jun Li Selom Agbobli-Nuwoaty Frank J. Palella Richard M. Novak Ellen Tedaldi Cynthia Mayer Jonathan D. Mahnken Qingjiang Hou Kimberly Carlson Angela M. Thompson-Paul Marcus D. Durham Kate Buchacz |
| author_facet | Jun Li Selom Agbobli-Nuwoaty Frank J. Palella Richard M. Novak Ellen Tedaldi Cynthia Mayer Jonathan D. Mahnken Qingjiang Hou Kimberly Carlson Angela M. Thompson-Paul Marcus D. Durham Kate Buchacz |
| author_sort | Jun Li |
| collection | DOAJ |
| description | Current U.S. guidelines recommend integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) as initial treatment for people with HIV (PWH). We assessed long-term effects of INSTI use on lipid profiles in routine HIV care. We analyzed medical record data from the HIV Outpatient Study’s participants in care from 2007 to 2021. Hyperlipidemia was defined based on clinical diagnoses, treatments, and laboratory results. We calculated hyperlipidemia incidence rates and rate ratios (RRs) during initial ART and assessed predictors of incident hyperlipidemia by using Poisson regression. Among 349 eligible ART-naïve PWH, 168 were prescribed INSTI-based ART (36 raltegravir (RAL), 51 dolutegravir (DTG), and 81 INSTI-others (elvitegravir and bictegravir)) and 181 non-INSTI-based ART, including 68 protease inhibitor (PI)-based ART. During a median follow-up of 1.4 years, hyperlipidemia rates were 12.8, 22.3, 22.7, 17.4, and 12.6 per 100 person years for RAL-, DTG-, INSTI-others-, non-INSTI-PI-, and non-INSTI-non-PI-based ART, respectively. In multivariable analysis, compared with the RAL group, hyperlipidemia rates were higher in INSTI-others (RR = 2.25; 95% confidence interval (CI): 1.29–3.93) and non-INSTI-PI groups (RR = 1.89; CI: 1.12–3.19) but not statistically higher for the DTG (RR = 1.73; CI: 0.95–3.17) and non-INSTI-non-PI groups (RR = 1.55; CI: 0.92–2.62). Other factors independently associated with hyperlipidemia included older age, non-Hispanic White race/ethnicity, and ART without tenofovir disoproxil fumarate. PWH using RAL-based regimens had lower rates of incident hyperlipidemia than PWH receiving non-INSTI-PI-based ART but had similar rates as those receiving DTG-based ART, supporting federal recommendations for using DTG-based regimens as the initial therapy for ART-naïve PWH. |
| format | Article |
| id | doaj-art-7fbd7d4db7274a7386d8c10901658088 |
| institution | Kabale University |
| issn | 2090-1259 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
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| series | AIDS Research and Treatment |
| spelling | doaj-art-7fbd7d4db7274a7386d8c109016580882025-02-03T01:29:35ZengWileyAIDS Research and Treatment2090-12592023-01-01202310.1155/2023/4423132Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021Jun Li0Selom Agbobli-Nuwoaty1Frank J. Palella2Richard M. Novak3Ellen Tedaldi4Cynthia Mayer5Jonathan D. Mahnken6Qingjiang Hou7Kimberly Carlson8Angela M. Thompson-Paul9Marcus D. Durham10Kate Buchacz11Division of HIV PreventionCerner CorporationNorthwestern University Feinberg School of MedicineUniversity of Illinois College of MedicineLewis Katz School of Medicine at Temple UniversitySt. Joseph’s Comprehensive Research InstituteCerner CorporationCerner CorporationCerner CorporationDivision for Heart Disease and Stroke PreventionDivision of HIV PreventionDivision of HIV PreventionCurrent U.S. guidelines recommend integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) as initial treatment for people with HIV (PWH). We assessed long-term effects of INSTI use on lipid profiles in routine HIV care. We analyzed medical record data from the HIV Outpatient Study’s participants in care from 2007 to 2021. Hyperlipidemia was defined based on clinical diagnoses, treatments, and laboratory results. We calculated hyperlipidemia incidence rates and rate ratios (RRs) during initial ART and assessed predictors of incident hyperlipidemia by using Poisson regression. Among 349 eligible ART-naïve PWH, 168 were prescribed INSTI-based ART (36 raltegravir (RAL), 51 dolutegravir (DTG), and 81 INSTI-others (elvitegravir and bictegravir)) and 181 non-INSTI-based ART, including 68 protease inhibitor (PI)-based ART. During a median follow-up of 1.4 years, hyperlipidemia rates were 12.8, 22.3, 22.7, 17.4, and 12.6 per 100 person years for RAL-, DTG-, INSTI-others-, non-INSTI-PI-, and non-INSTI-non-PI-based ART, respectively. In multivariable analysis, compared with the RAL group, hyperlipidemia rates were higher in INSTI-others (RR = 2.25; 95% confidence interval (CI): 1.29–3.93) and non-INSTI-PI groups (RR = 1.89; CI: 1.12–3.19) but not statistically higher for the DTG (RR = 1.73; CI: 0.95–3.17) and non-INSTI-non-PI groups (RR = 1.55; CI: 0.92–2.62). Other factors independently associated with hyperlipidemia included older age, non-Hispanic White race/ethnicity, and ART without tenofovir disoproxil fumarate. PWH using RAL-based regimens had lower rates of incident hyperlipidemia than PWH receiving non-INSTI-PI-based ART but had similar rates as those receiving DTG-based ART, supporting federal recommendations for using DTG-based regimens as the initial therapy for ART-naïve PWH.http://dx.doi.org/10.1155/2023/4423132 |
| spellingShingle | Jun Li Selom Agbobli-Nuwoaty Frank J. Palella Richard M. Novak Ellen Tedaldi Cynthia Mayer Jonathan D. Mahnken Qingjiang Hou Kimberly Carlson Angela M. Thompson-Paul Marcus D. Durham Kate Buchacz Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 AIDS Research and Treatment |
| title | Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 |
| title_full | Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 |
| title_fullStr | Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 |
| title_full_unstemmed | Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 |
| title_short | Incidence of Hyperlipidemia among Adults Initiating Antiretroviral Therapy in the HIV Outpatient Study (HOPS), USA, 2007–2021 |
| title_sort | incidence of hyperlipidemia among adults initiating antiretroviral therapy in the hiv outpatient study hops usa 2007 2021 |
| url | http://dx.doi.org/10.1155/2023/4423132 |
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