Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

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  • The Respond Study Group

Objective: To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts. Methods: Eligible people with HIV were aged ≥18 years who initiated a new three-drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow-up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ≥140 mmHg and/or diastolic BP ≥90 mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART naïve or experienced at baseline. Results: Overall, 4606 people living with HIV were eligible (INSTIs 3164, NNRTIs 807, PIs 635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113–130) mmHg, 78 (70–82) mmHg, and 43 (34–50) years, respectively. Over 8380.4 person-years (median follow-up 1.5 [IQR 1.0–2.7] years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person-years, 95% confidence interval [CI] 118.9–134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76; 95% CI 1.47–2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07; 95% CI 0.89–1.29). The results were similar when the analysis was stratified by ART status at baseline. Conclusion: Although unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART-naïve and ART-experienced participants within RESPOND.

OriginalsprogEngelsk
TidsskriftHIV Medicine
Vol/bind23
Udgave nummer8
Sider (fra-til)895-910
ISSN1464-2662
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The International Cohort Consortium of Infectious Disease (RESPOND) has received funding from ViiV Healthcare LLC and Gilead Sciences and Merck Sharp & Dohme. Additional support has been provided by participating cohorts contributing data in‐kind and/or statistical support: Austrian HIV Cohort Study (AHIVCOS); The Australian HIV Observational Database (AHOD); CHU Saint‐Pierre, University Hospital Cologne; EuroSIDA; Frankfurt HIV Cohort Study; Georgian National AIDS Health Information System (AIDS HIS); Modena HIV Cohort; San Raffaele Scientific Institute; Swiss HIV Cohort Study (SHCS); AIDS Therapy Evaluation in the Netherlands Cohort (ATHENA); Royal Free HIV Cohort Study. AHOD is further supported by grant no. U01‐AI069907 from the U.S. National Institutes of Health and GNT1050874 of the National Health and Medical Research Council, Australia. Funding companies had no direct involvement in the conduct of scientific projects. Funders had no direct role in study design, data collection, data analysis and/or data interpretation.

Funding Information:
The International Cohort Consortium of Infectious Disease (RESPOND) has received funding from ViiV Healthcare LLC and Gilead Sciences and Merck Sharp & Dohme. Additional support has been provided by participating cohorts contributing data in-kind and/or statistical support: Austrian HIV Cohort Study (AHIVCOS); The Australian HIV Observational Database (AHOD); CHU Saint-Pierre, University Hospital Cologne; EuroSIDA; Frankfurt HIV Cohort Study; Georgian National AIDS Health Information System (AIDS HIS); Modena HIV Cohort; San Raffaele Scientific Institute; Swiss HIV Cohort Study (SHCS); AIDS Therapy Evaluation in the Netherlands Cohort (ATHENA); Royal Free HIV Cohort Study. AHOD is further supported by grant no. U01-AI069907 from the U.S. National Institutes of Health and GNT1050874 of the National Health and Medical Research Council, Australia. Funding companies had no direct involvement in the conduct of scientific projects.

Publisher Copyright:
© 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

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