IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0059551.html
   My bibliography  Save this article

Risk of Cardiovascular Disease from Antiretroviral Therapy for HIV: A Systematic Review

Author

Listed:
  • Clay Bavinger
  • Eran Bendavid
  • Katherine Niehaus
  • Richard A Olshen
  • Ingram Olkin
  • Vandana Sundaram
  • Nicole Wein
  • Mark Holodniy
  • Nanjiang Hou
  • Douglas K Owens
  • Manisha Desai

Abstract

Background: Recent studies suggest certain antiretroviral therapy (ART) drugs are associated with increases in cardiovascular disease. Purpose: We performed a systematic review and meta-analysis to summarize the available evidence, with the goal of elucidating whether specific ART drugs are associated with an increased risk of myocardial infarction (MI). Data Sources: We searched Medline, Web of Science, the Cochrane Library, and abstract archives from the Conference on Retroviruses and Opportunistic Infections and International AIDS Society up to June 2011 to identify published articles and abstracts. Study Selection: Eligible studies were comparative and included MI, strokes, or other cardiovascular events as outcomes. Data Extraction: Eligibility screening, data extraction, and quality assessment were performed independently by two investigators. Data Synthesis: Random effects methods and Fisher’s combined probability test were used to summarize evidence. Findings: Twenty-seven studies met inclusion criteria, with 8 contributing to a formal meta-analysis. Findings based on two observational studies indicated an increase in risk of MI for patients recently exposed (usually defined as within last 6 months) to abacavir (RR 1.92, 95% CI 1.51–2.42) and protease inhibitors (PI) (RR 2.13, 95% CI 1.06–4.28). Our analysis also suggested an increased risk associated with each additional year of exposure to indinavir (RR 1.11, 95% CI 1.05–1.17) and lopinavir (RR 1.22, 95% CI 1.01–1.47). Our findings of increased cardiovascular risk from abacavir and PIs were in contrast to four published meta-analyses based on secondary analyses of randomized controlled trials, which found no increased risk from cardiovascular disease. Conclusion: Although observational studies implicated specific drugs, the evidence is mixed. Further, meta-analyses of randomized trials did not find increased risk from abacavir and PIs. Our findings that implicate specific ARTs in the observational setting provide sufficient evidence to warrant further investigation of this relationship in studies designed for that purpose.

Suggested Citation

  • Clay Bavinger & Eran Bendavid & Katherine Niehaus & Richard A Olshen & Ingram Olkin & Vandana Sundaram & Nicole Wein & Mark Holodniy & Nanjiang Hou & Douglas K Owens & Manisha Desai, 2013. "Risk of Cardiovascular Disease from Antiretroviral Therapy for HIV: A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0059551
    DOI: 10.1371/journal.pone.0059551
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059551
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0059551&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0059551?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Viechtbauer, Wolfgang, 2010. "Conducting Meta-Analyses in R with the metafor Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 36(i03).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pierre Gantner & Firouze Bani-Sadr & Rodolphe Garraffo & Pierre-Marie Roger & Michèle Treger & Thomas Jovelin & Pascal Pugliese & David Rey & Dat’AIDS cohort, 2016. "Switch to Ritonavir-Boosted versus Unboosted Atazanavir plus Raltegravir Dual-Drug Therapy Leads to Similar Efficacy and Safety Outcomes in Clinical Practice," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-13, October.
    2. Parveen Kumar & Christophe Arendt & Simon Martin & Safaa Al Soufi & Philipp DeLeuw & Eike Nagel & Valentina O. Puntmann, 2023. "Multimodality Imaging in HIV-Associated Cardiovascular Complications: A Comprehensive Review," IJERPH, MDPI, vol. 20(3), pages 1-18, January.
    3. Yongling Xiao & Michal Abrahamowicz & Erica E. M. Moodie & Rainer Weber & James Young, 2014. "Flexible Marginal Structural Models for Estimating the Cumulative Effect of a Time-Dependent Treatment on the Hazard: Reassessing the Cardiovascular Risks of Didanosine Treatment in the Swiss HIV Coho," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 109(506), pages 455-464, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Whitney S Beck & Ed K Hall, 2018. "Confounding factors in algal phosphorus limitation experiments," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-19, October.
    2. Xindong Xue & W. Robert Reed & Robbie C.M. van Aert, 2022. "Social Capital and Economic Growth: A Meta-Analysis," Working Papers in Economics 22/20, University of Canterbury, Department of Economics and Finance.
    3. Bart Verkuil & Serpil Atasayi & Marc L Molendijk, 2015. "Workplace Bullying and Mental Health: A Meta-Analysis on Cross-Sectional and Longitudinal Data," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-16, August.
    4. Francesca Pilotto & Ingolf Kühn & Rita Adrian & Renate Alber & Audrey Alignier & Christopher Andrews & Jaana Bäck & Luc Barbaro & Deborah Beaumont & Natalie Beenaerts & Sue Benham & David S. Boukal & , 2020. "Meta-analysis of multidecadal biodiversity trends in Europe," Nature Communications, Nature, vol. 11(1), pages 1-11, December.
    5. repec:cup:judgdm:v:15:y:2020:i:6:p:972-988 is not listed on IDEAS
    6. Jonas Schmidt & Tammo H. A. Bijmolt, 2020. "Accurately measuring willingness to pay for consumer goods: a meta-analysis of the hypothetical bias," Journal of the Academy of Marketing Science, Springer, vol. 48(3), pages 499-518, May.
    7. Mario Herberz & Tobias Brosch & Ulf J. J. Hahnel, 2020. "Kilo what? Default units increase value sensitivity in joint evaluations of energy efficiency," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 15(6), pages 972-988, November.
    8. Piers Steel & Sjoerd Beugelsdijk & Herman Aguinis, 2021. "The anatomy of an award-winning meta-analysis: Recommendations for authors, reviewers, and readers of meta-analytic reviews," Journal of International Business Studies, Palgrave Macmillan;Academy of International Business, vol. 52(1), pages 23-44, February.
    9. Augusteijn, Hilde Elisabeth Maria & van Aert, Robbie Cornelis Maria & van Assen, Marcel A. L. M., 2021. "Posterior Probabilities of Effect Sizes and Heterogeneity in Meta-Analysis: An Intuitive Approach of Dealing with Publication Bias," OSF Preprints avkgj, Center for Open Science.
    10. Georgiou, George K. & Guo, Kan & Naveenkumar, Nithya & Vieira, Ana Paula Alves & Das, J.P., 2020. "PASS theory of intelligence and academic achievement: A meta-analytic review," Intelligence, Elsevier, vol. 79(C).
    11. Geller, Susann & Wilhelm, Oliver & Wacker, Jan & Hamm, Alfons & Hildebrandt, Andrea, 2017. "Associations of the COMT Val158Met polymorphism with working memory and intelligence – A review and meta-analysis," Intelligence, Elsevier, vol. 65(C), pages 75-92.
    12. Gignac, Gilles E. & Bates, Timothy C., 2017. "Brain volume and intelligence: The moderating role of intelligence measurement quality," Intelligence, Elsevier, vol. 64(C), pages 18-29.
    13. Stephan Kambach & Ingolf Kühn & Bastien Castagneyrol & Helge Bruelheide, 2016. "The Impact of Tree Diversity on Different Aspects of Insect Herbivory along a Global Temperature Gradient - A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-14, November.
    14. Julian Packheiser & Helena Hartmann & Kelly Fredriksen & Valeria Gazzola & Christian Keysers & Frédéric Michon, 2024. "A systematic review and multivariate meta-analysis of the physical and mental health benefits of touch interventions," Nature Human Behaviour, Nature, vol. 8(6), pages 1088-1107, June.
    15. Nan Wang & Yuxiang Luan & Rui Ma, 2024. "Detecting causal relationships between work motivation and job performance: a meta-analytic review of cross-lagged studies," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-10, December.
    16. repec:cup:judgdm:v:14:y:2019:i:3:p:234-279 is not listed on IDEAS
    17. Senlin Zhou & Yunpeng Wu & Xizheng Xu, 2023. "Linking Cognitive Reappraisal and Expressive Suppression to Mindfulness: A Three-Level Meta-Analysis," IJERPH, MDPI, vol. 20(2), pages 1-16, January.
    18. Mahesh Shumsher Rughooputh & Rui Zeng & Ying Yao, 2015. "Protein Diet Restriction Slows Chronic Kidney Disease Progression in Non-Diabetic and in Type 1 Diabetic Patients, but Not in Type 2 Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials ," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-17, December.
    19. de la Cruz, Vera Ysabel V. & Tantriani, & Cheng, Weiguo & Tawaraya, Keitaro, 2023. "Yield gap between organic and conventional farming systems across climate types and sub-types: A meta-analysis," Agricultural Systems, Elsevier, vol. 211(C).
    20. Christopher Winchester & Kelsey E. Medeiros, 2023. "In Bounds but Out of the Box: A Meta-Analysis Clarifying the Effect of Ethicality on Creativity," Journal of Business Ethics, Springer, vol. 183(3), pages 713-743, March.
    21. Kelly R Moran & Sara Y Del Valle, 2016. "A Meta-Analysis of the Association between Gender and Protective Behaviors in Response to Respiratory Epidemics and Pandemics," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-25, October.
    22. Cyrielle Maroteau & Antonio Espuela-Ortiz & Esther Herrera-Luis & Sundararajan Srinivasan & Fiona Carr & Roger Tavendale & Karen Wilson & Natalia Hernandez-Pacheco & James D Chalmers & Steve Turner & , 2021. "LTA4H rs2660845 association with montelukast response in early and late-onset asthma," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-17, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0059551. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.