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

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

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)271-279
Number of pages9
JournalAntiviral therapy
Volume24
Issue number4
DOIs
Publication statusPublished - 2019 Jan 1

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Cardiovascular Diseases
HIV
Databases
Incidence
Lopinavir
Smoking Cessation
HDL Cholesterol
Cardiovascular Models
Cholesterol
Hypertension
LDL Cholesterol
Therapeutics
Mortality
Population

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific. / Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD). In: Antiviral therapy. 2019 ; Vol. 24, No. 4. pp. 271-279.
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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 Lh} 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",
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TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific 2019, 'Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)', Antiviral therapy, vol. 24, no. 4, pp. 271-279. https://doi.org/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.

In: Antiviral therapy, Vol. 24, No. 4, 01.01.2019, p. 271-279.

Research output: Contribution to journalArticle

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 Lh

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

PY - 2019/1/1

Y1 - 2019/1/1

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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TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific. Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD). Antiviral therapy. 2019 Jan 1;24(4):271-279. https://doi.org/10.3851/IMP3298