Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium. Issue 8 (1st March 2022)

• Record Type: Journal Article
• Authors: Byonanebye, Dathan M.; Polizzotto, Mark N.; Neesgaard, Bastian; Sarcletti, Mario; Matulionyte, Raimonda; Braun, Dominique L.; Castagna, Antonella; de Wit, Stéphane; Wit, Ferdinand; Fontas, Eric; Vehreschild, Jörg Janne; Vesterbacka, Jan; Greenberg, Lauren; Hatleberg, Camilla; Garges, Harmony; Gallant, Joel; Volny Anne, Alain; Öllinger, Angela; Mozer‐Lisewska, Iwona; Surial, Bernard; Spagnuolo, Vincenzo; Necsoi, Coca; van der Valk, Marc; Mocroft, Amanda; Law, Matthew; Ryom, Lene; Petoumenos, Kathy
• Other Names: Hillebregt M investigator.; Rose N investigator.; Hutchinson J investigator.; Zangerle R investigator.; Appoyer H investigator.; Delforge M investigator.; Stephan C investigator.; Bucht M investigator.; Chkhartishvili N investigator.; Chokoshvili O investigator.; Mussini C investigator.; Borghi V investigator.; Pradier C investigator.; Dollet K investigator.; Caissotti C investigator.; Casabona J investigator.; Miro JM investigator.; Smith C investigator.; Lampe F investigator.; Johnson M investigator.; Burns F investigator.; Chaloner C investigator.; Lazzarin A investigator.; Poli A investigator.; Sönnerborg A investigator.; Falconer K investigator.; Svedhem V investigator.; Günthard H investigator.; Ledergerber B investigator.; Bucher H investigator.; Scherrer A investigator.; Wasmuth JC investigator.; Rockstroh J investigator.; Fätkenheuer G investigator.; Stecher M investigator.; Schulze N investigator.; Franke B investigator.; Ryom Lene investigator.; Rooney J investigator.; McNicholl I investigator.; Vannappagari V investigator.; Wandeler G investigator.; Lundgren J investigator.; Kowalska J investigator.; Raben D investigator.; Mocroft A investigator.; Peters L investigator.; Williams ED investigator.; Necsoi C investigator.; D'Arminio Monforte A investigator.; Bruguera A investigator.; Dedes Nikos investigator.; Mendao Luis investigator.; Larsen JF investigator.; Jaschinski N investigator.; Jakobsen ML investigator.; Bruun T investigator.; Bojesen A investigator.; Hansen EV investigator.; Traytel AK investigator.; Elsing TW investigator.; Kristensen D investigator.; Weide T investigator.; Bansi‐Matharu L investigator.; Pelchen‐Matthews A investigator.;
• Is Part Of: HIV medicine. Volume 23:Issue 8(2022)
• Page Start: 895
• Page End: 910
• Publication Date: 2022-03-01
• Subjects: antiretroviral agents -- HIV -- hypertension -- integrase inhibitors; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.13273
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract: 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.