Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)

TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

doi:10.3851/IMP3298

Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)

TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: We aimed to project the 10-year future incidence of cardiovascular disease (CVD) and model several intervention scenarios based on a multi-site Asian HIV-positive cohort. Methods: Analyses were based on patients recruited to the TREAT Asia HIV Observational Database (TAHOD), consisting of 21 sites in 12 countries. Patients on triple antiretroviral therapy (ART) were included if they were alive, without previous CVD, and had data on CVD risk factors. Annual new CVD events for 2019–2028 were estimated with the D:A:D equation, accounting for age- and sex-adjusted mortality. Modelled intervention scenarios were treatment of high total cholesterol, low high-density lipoprotein cholesterol (HDL) or high blood pressure, abacavir or lopinavir substitution, and smoking cessation. Results: Of 3,703 included patients, 69% were male, median age was 46 (IQR 40–53) years and median time since ART initiation was 9.8 years (IQR 7.5–14.1). Cohort incidence rates of CVD were projected to increase from 730 per 100,000 person-years (pys) in 2019 to 1,432 per 100,000 pys in 2028. In the modelled intervention scenarios, most events can be avoided by smoking cessation, abacavir substitution, lopinavir substitution, decreasing total cholesterol, treating high blood pressure and increasing HDL. Conclusions: Our projections suggest a doubling of CVD incidence rates in Asian HIV-positive adults in our cohort. An increase in CVD can be expected in any ageing population, however, according to our models, this can be close to averted by interventions. Thus, there is an urgent need for risk screening and integration of HIV and CVD programmes to reduce the future CVD burden.

Original language	English
Pages (from-to)	271-279
Number of pages	9
Journal	Antiviral therapy
Volume	24
Issue number	4
DOIs	https://doi.org/10.3851/IMP3298
Publication status	Published - 2019

Bibliographical note

Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA) [grant number: U01AI069907]. The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The PhD of RB has been supported through an Australian Government Research Training Program Scholarship. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Further acknowledgements can be found in Additional file 3.

Publisher Copyright:
©2019 International Medical Press

All Science Journal Classification (ASJC) codes

Pharmacology
Pharmacology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3851/IMP3298

Cite this

@article{98f4b257ce024b46846ce90ddd68a5ef,

title = "Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)",

abstract = "Background: We aimed to project the 10-year future incidence of cardiovascular disease (CVD) and model several intervention scenarios based on a multi-site Asian HIV-positive cohort. Methods: Analyses were based on patients recruited to the TREAT Asia HIV Observational Database (TAHOD), consisting of 21 sites in 12 countries. Patients on triple antiretroviral therapy (ART) were included if they were alive, without previous CVD, and had data on CVD risk factors. Annual new CVD events for 2019–2028 were estimated with the D:A:D equation, accounting for age- and sex-adjusted mortality. Modelled intervention scenarios were treatment of high total cholesterol, low high-density lipoprotein cholesterol (HDL) or high blood pressure, abacavir or lopinavir substitution, and smoking cessation. Results: Of 3,703 included patients, 69% were male, median age was 46 (IQR 40–53) years and median time since ART initiation was 9.8 years (IQR 7.5–14.1). Cohort incidence rates of CVD were projected to increase from 730 per 100,000 person-years (pys) in 2019 to 1,432 per 100,000 pys in 2028. In the modelled intervention scenarios, most events can be avoided by smoking cessation, abacavir substitution, lopinavir substitution, decreasing total cholesterol, treating high blood pressure and increasing HDL. Conclusions: Our projections suggest a doubling of CVD incidence rates in Asian HIV-positive adults in our cohort. An increase in CVD can be expected in any ageing population, however, according to our models, this can be close to averted by interventions. Thus, there is an urgent need for risk screening and integration of HIV and CVD programmes to reduce the future CVD burden.",

author = "{TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific} and Rimke Bijker and Nagalingeswaran Kumarasamy and Sasisopin Kiertiburanakul and Sanjay Pujari and Wilson Lam and Romanee Chaiwarith and Wong, {Wing W.} and Adeeba Kamarulzaman and Pacharee Kantipong and Anchalee Avihingsanon and Nguyen, {Kinh V.} and Junko Tanuma and Ng, {Oon Tek} and Sim, {Benedict L.H.} and Merati, {Tuti P.} and Choi, {Jun Y.} and Rossana Ditangco and Evy Yunihastuti and Sun, {Ly P.} and Do, {Cuong D.} and Jeremy Ross and Matthew Law",

note = "Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA) [grant number: U01AI069907]. The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The PhD of RB has been supported through an Australian Government Research Training Program Scholarship. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Further acknowledgements can be found in Additional file 3. Publisher Copyright: {\textcopyright}2019 International Medical Press",

year = "2019",

doi = "10.3851/IMP3298",

language = "English",

volume = "24",

pages = "271--279",

journal = "Antiviral therapy",

issn = "1359-6535",

publisher = "International Medical Press Ltd",

number = "4",

}

TY - JOUR

T1 - Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)

AU - TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

AU - Bijker, Rimke

AU - Kumarasamy, Nagalingeswaran

AU - Kiertiburanakul, Sasisopin

AU - Pujari, Sanjay

AU - Lam, Wilson

AU - Chaiwarith, Romanee

AU - Wong, Wing W.

AU - Kamarulzaman, Adeeba

AU - Kantipong, Pacharee

AU - Avihingsanon, Anchalee

AU - Nguyen, Kinh V.

AU - Tanuma, Junko

AU - Ng, Oon Tek

AU - Sim, Benedict L.H.

AU - Merati, Tuti P.

AU - Choi, Jun Y.

AU - Ditangco, Rossana

AU - Yunihastuti, Evy

AU - Sun, Ly P.

AU - Do, Cuong D.

AU - Ross, Jeremy

AU - Law, Matthew

N1 - Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA) [grant number: U01AI069907]. The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The PhD of RB has been supported through an Australian Government Research Training Program Scholarship. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Further acknowledgements can be found in Additional file 3. Publisher Copyright: ©2019 International Medical Press

PY - 2019

Y1 - 2019

N2 - Background: We aimed to project the 10-year future incidence of cardiovascular disease (CVD) and model several intervention scenarios based on a multi-site Asian HIV-positive cohort. Methods: Analyses were based on patients recruited to the TREAT Asia HIV Observational Database (TAHOD), consisting of 21 sites in 12 countries. Patients on triple antiretroviral therapy (ART) were included if they were alive, without previous CVD, and had data on CVD risk factors. Annual new CVD events for 2019–2028 were estimated with the D:A:D equation, accounting for age- and sex-adjusted mortality. Modelled intervention scenarios were treatment of high total cholesterol, low high-density lipoprotein cholesterol (HDL) or high blood pressure, abacavir or lopinavir substitution, and smoking cessation. Results: Of 3,703 included patients, 69% were male, median age was 46 (IQR 40–53) years and median time since ART initiation was 9.8 years (IQR 7.5–14.1). Cohort incidence rates of CVD were projected to increase from 730 per 100,000 person-years (pys) in 2019 to 1,432 per 100,000 pys in 2028. In the modelled intervention scenarios, most events can be avoided by smoking cessation, abacavir substitution, lopinavir substitution, decreasing total cholesterol, treating high blood pressure and increasing HDL. Conclusions: Our projections suggest a doubling of CVD incidence rates in Asian HIV-positive adults in our cohort. An increase in CVD can be expected in any ageing population, however, according to our models, this can be close to averted by interventions. Thus, there is an urgent need for risk screening and integration of HIV and CVD programmes to reduce the future CVD burden.

AB - Background: We aimed to project the 10-year future incidence of cardiovascular disease (CVD) and model several intervention scenarios based on a multi-site Asian HIV-positive cohort. Methods: Analyses were based on patients recruited to the TREAT Asia HIV Observational Database (TAHOD), consisting of 21 sites in 12 countries. Patients on triple antiretroviral therapy (ART) were included if they were alive, without previous CVD, and had data on CVD risk factors. Annual new CVD events for 2019–2028 were estimated with the D:A:D equation, accounting for age- and sex-adjusted mortality. Modelled intervention scenarios were treatment of high total cholesterol, low high-density lipoprotein cholesterol (HDL) or high blood pressure, abacavir or lopinavir substitution, and smoking cessation. Results: Of 3,703 included patients, 69% were male, median age was 46 (IQR 40–53) years and median time since ART initiation was 9.8 years (IQR 7.5–14.1). Cohort incidence rates of CVD were projected to increase from 730 per 100,000 person-years (pys) in 2019 to 1,432 per 100,000 pys in 2028. In the modelled intervention scenarios, most events can be avoided by smoking cessation, abacavir substitution, lopinavir substitution, decreasing total cholesterol, treating high blood pressure and increasing HDL. Conclusions: Our projections suggest a doubling of CVD incidence rates in Asian HIV-positive adults in our cohort. An increase in CVD can be expected in any ageing population, however, according to our models, this can be close to averted by interventions. Thus, there is an urgent need for risk screening and integration of HIV and CVD programmes to reduce the future CVD burden.

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U2 - 10.3851/IMP3298

DO - 10.3851/IMP3298

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AN - SCOPUS:85074380127

SN - 1359-6535

VL - 24

SP - 271

EP - 279

JO - Antiviral therapy

JF - Antiviral therapy

IS - 4

ER -

Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

Access to Document

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