Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study
To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors. Nationwide, population-based cohort study. The study population included all Danish HIV...
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| Veröffentlicht in: | AIDS (London) 2011-08, Vol.25 (13), p.1637-1646 |
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| creator | RASMUSSEN, Line D ENGSIG, Frederik N CHRISTENSEN, Hanne GERSTOFT, Jan KRONBORG, Gitte PEDERSEN, Court OBEL, Niels |
| description | To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors.
Nationwide, population-based cohort study.
The study population included all Danish HIV-infected individuals, a population-based comparison cohort and parents of both cohorts - all with no prior cerebral comorbidity. We computed incidence rate ratios (IRRs) of overall CVEs and CVEs with and without proven risk factors, stratifying the analyses on IDU. Impact of immunodeficiency, HAART, protease inhibitors, indinavir, didanosin, tenofovir and abacavir on risk of CVEs was analyzed using time-dependent Cox regression analyses.
HIV-infected individuals had an increased risk of CVEs compared with the comparison cohorts [(non-IDU HIV adjusted IRR 1.60; 95% confidence interval [CI] 1.32-1.94), (IDU HIV adjusted IRR 3.94; 95% CI 2.16-7.16)]. The risk was increased with and without proven risk factors. A CD4 cell count of 200 cells/μl or less before the start of HAART and exposure to abacavir increased the risk of CVE [(adjusted IRR 2.26; 95% CI 1.05-4.86) and (adjusted IRR 1.66; 95% CI 1.03-2.68)]. Protease inhibitors, indinavir, didanosin, tenofovir and HAART in general had no impact. Risk of CVEs was only increased in the parents of IDU HIV-infected individuals.
HIV-infected individuals have an increased risk of CVEs with and without proven risk factors. The risk is associated with IDU, low CD4 cell count and exposure to abacavir, but not with HAART. An association with family-related risk factors seems vague except for parents of IDU individuals. |
| doi_str_mv | 10.1097/QAD.0b013e3283493fb0 |
| format | Article |
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Nationwide, population-based cohort study.
The study population included all Danish HIV-infected individuals, a population-based comparison cohort and parents of both cohorts - all with no prior cerebral comorbidity. We computed incidence rate ratios (IRRs) of overall CVEs and CVEs with and without proven risk factors, stratifying the analyses on IDU. Impact of immunodeficiency, HAART, protease inhibitors, indinavir, didanosin, tenofovir and abacavir on risk of CVEs was analyzed using time-dependent Cox regression analyses.
HIV-infected individuals had an increased risk of CVEs compared with the comparison cohorts [(non-IDU HIV adjusted IRR 1.60; 95% confidence interval [CI] 1.32-1.94), (IDU HIV adjusted IRR 3.94; 95% CI 2.16-7.16)]. The risk was increased with and without proven risk factors. A CD4 cell count of 200 cells/μl or less before the start of HAART and exposure to abacavir increased the risk of CVE [(adjusted IRR 2.26; 95% CI 1.05-4.86) and (adjusted IRR 1.66; 95% CI 1.03-2.68)]. Protease inhibitors, indinavir, didanosin, tenofovir and HAART in general had no impact. Risk of CVEs was only increased in the parents of IDU HIV-infected individuals.
HIV-infected individuals have an increased risk of CVEs with and without proven risk factors. The risk is associated with IDU, low CD4 cell count and exposure to abacavir, but not with HAART. An association with family-related risk factors seems vague except for parents of IDU individuals.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0b013e3283493fb0</identifier><identifier>PMID: 21646903</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; AIDS/HIV ; Anti-HIV Agents - adverse effects ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral Therapy, Highly Active - adverse effects ; Antiviral agents ; Biological and medical sciences ; CD4 Lymphocyte Count ; Cerebrovascular Disorders - complications ; Cerebrovascular Disorders - epidemiology ; Denmark - epidemiology ; Female ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Incidence ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Neurology ; Parents ; Pharmacology. Drug treatments ; Risk Factors ; Substance Abuse, Intravenous - complications ; Substance Abuse, Intravenous - epidemiology ; Vascular diseases and vascular malformations of the nervous system ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>AIDS (London), 2011-08, Vol.25 (13), p.1637-1646</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c317t-697ddd4448960d308ddfd329084507befe9bcc32da6e3d694c6f14806e56c2063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24473647$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21646903$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>RASMUSSEN, Line D</creatorcontrib><creatorcontrib>ENGSIG, Frederik N</creatorcontrib><creatorcontrib>CHRISTENSEN, Hanne</creatorcontrib><creatorcontrib>GERSTOFT, Jan</creatorcontrib><creatorcontrib>KRONBORG, Gitte</creatorcontrib><creatorcontrib>PEDERSEN, Court</creatorcontrib><creatorcontrib>OBEL, Niels</creatorcontrib><title>Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors.
Nationwide, population-based cohort study.
The study population included all Danish HIV-infected individuals, a population-based comparison cohort and parents of both cohorts - all with no prior cerebral comorbidity. We computed incidence rate ratios (IRRs) of overall CVEs and CVEs with and without proven risk factors, stratifying the analyses on IDU. Impact of immunodeficiency, HAART, protease inhibitors, indinavir, didanosin, tenofovir and abacavir on risk of CVEs was analyzed using time-dependent Cox regression analyses.
HIV-infected individuals had an increased risk of CVEs compared with the comparison cohorts [(non-IDU HIV adjusted IRR 1.60; 95% confidence interval [CI] 1.32-1.94), (IDU HIV adjusted IRR 3.94; 95% CI 2.16-7.16)]. The risk was increased with and without proven risk factors. A CD4 cell count of 200 cells/μl or less before the start of HAART and exposure to abacavir increased the risk of CVE [(adjusted IRR 2.26; 95% CI 1.05-4.86) and (adjusted IRR 1.66; 95% CI 1.03-2.68)]. Protease inhibitors, indinavir, didanosin, tenofovir and HAART in general had no impact. Risk of CVEs was only increased in the parents of IDU HIV-infected individuals.
HIV-infected individuals have an increased risk of CVEs with and without proven risk factors. The risk is associated with IDU, low CD4 cell count and exposure to abacavir, but not with HAART. An association with family-related risk factors seems vague except for parents of IDU individuals.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral Therapy, Highly Active - adverse effects</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Cerebrovascular Disorders - complications</subject><subject>Cerebrovascular Disorders - epidemiology</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Parents</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Substance Abuse, Intravenous - complications</subject><subject>Substance Abuse, Intravenous - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFLHTEQx4O01KftN5CSS_G0Otlks0lvorUKQmlpe12yySwvdl-yJruK37559dmClx7CZOA3_4H5EXLE4ISBbk-_nl2cQA-MI68VF5oPPeyRFRMtr5qmZa_ICmqpK81b2CcHOd8CQANKvSH7NZNCauArcvfN5180DtRiwj7Fe5PtMppE8R7DnKkPdMKUY8j0wc9raoL784nLTK-uf36khl6Y4POaBjP7GB68QzrFqWRs26o3GR21cR3TTPO8uMe35PVgxozvdvWQ_Lj89P38qrr58vn6_Oymspy1cyV165wTQigtwXFQzg2O1xqUaKDtcUDdW8trZyRyJ7WwcmBCgcRG2hokPyTHT7lTincL5rnb-GxxHE3AuOROac224fr_pCoHB6abQoon0qaYc8Khm5LfmPTYMei2VrpipXtppYy93y1Y-g26v0PPGgrwYQeU85txSCZYn_9xokiV5f0G-bOXMg</recordid><startdate>20110824</startdate><enddate>20110824</enddate><creator>RASMUSSEN, Line D</creator><creator>ENGSIG, Frederik N</creator><creator>CHRISTENSEN, Hanne</creator><creator>GERSTOFT, Jan</creator><creator>KRONBORG, Gitte</creator><creator>PEDERSEN, Court</creator><creator>OBEL, Niels</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20110824</creationdate><title>Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study</title><author>RASMUSSEN, Line D ; ENGSIG, Frederik N ; CHRISTENSEN, Hanne ; GERSTOFT, Jan ; KRONBORG, Gitte ; PEDERSEN, Court ; OBEL, Niels</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c317t-697ddd4448960d308ddfd329084507befe9bcc32da6e3d694c6f14806e56c2063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiretroviral Therapy, Highly Active - adverse effects</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Cerebrovascular Disorders - complications</topic><topic>Cerebrovascular Disorders - epidemiology</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Parents</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk Factors</topic><topic>Substance Abuse, Intravenous - complications</topic><topic>Substance Abuse, Intravenous - epidemiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>RASMUSSEN, Line D</creatorcontrib><creatorcontrib>ENGSIG, Frederik N</creatorcontrib><creatorcontrib>CHRISTENSEN, Hanne</creatorcontrib><creatorcontrib>GERSTOFT, Jan</creatorcontrib><creatorcontrib>KRONBORG, Gitte</creatorcontrib><creatorcontrib>PEDERSEN, Court</creatorcontrib><creatorcontrib>OBEL, Niels</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>RASMUSSEN, Line D</au><au>ENGSIG, Frederik N</au><au>CHRISTENSEN, Hanne</au><au>GERSTOFT, Jan</au><au>KRONBORG, Gitte</au><au>PEDERSEN, Court</au><au>OBEL, Niels</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2011-08-24</date><risdate>2011</risdate><volume>25</volume><issue>13</issue><spage>1637</spage><epage>1646</epage><pages>1637-1646</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors.
Nationwide, population-based cohort study.
The study population included all Danish HIV-infected individuals, a population-based comparison cohort and parents of both cohorts - all with no prior cerebral comorbidity. We computed incidence rate ratios (IRRs) of overall CVEs and CVEs with and without proven risk factors, stratifying the analyses on IDU. Impact of immunodeficiency, HAART, protease inhibitors, indinavir, didanosin, tenofovir and abacavir on risk of CVEs was analyzed using time-dependent Cox regression analyses.
HIV-infected individuals had an increased risk of CVEs compared with the comparison cohorts [(non-IDU HIV adjusted IRR 1.60; 95% confidence interval [CI] 1.32-1.94), (IDU HIV adjusted IRR 3.94; 95% CI 2.16-7.16)]. The risk was increased with and without proven risk factors. A CD4 cell count of 200 cells/μl or less before the start of HAART and exposure to abacavir increased the risk of CVE [(adjusted IRR 2.26; 95% CI 1.05-4.86) and (adjusted IRR 1.66; 95% CI 1.03-2.68)]. Protease inhibitors, indinavir, didanosin, tenofovir and HAART in general had no impact. Risk of CVEs was only increased in the parents of IDU HIV-infected individuals.
HIV-infected individuals have an increased risk of CVEs with and without proven risk factors. The risk is associated with IDU, low CD4 cell count and exposure to abacavir, but not with HAART. An association with family-related risk factors seems vague except for parents of IDU individuals.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>21646903</pmid><doi>10.1097/QAD.0b013e3283493fb0</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-9370 |
| ispartof | AIDS (London), 2011-08, Vol.25 (13), p.1637-1646 |
| issn | 0269-9370 1473-5571 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult AIDS/HIV Anti-HIV Agents - adverse effects Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral Therapy, Highly Active - adverse effects Antiviral agents Biological and medical sciences CD4 Lymphocyte Count Cerebrovascular Disorders - complications Cerebrovascular Disorders - epidemiology Denmark - epidemiology Female HIV Infections - complications HIV Infections - drug therapy HIV Infections - epidemiology Human immunodeficiency virus Human viral diseases Humans Incidence Infectious diseases Male Medical sciences Middle Aged Neurology Parents Pharmacology. Drug treatments Risk Factors Substance Abuse, Intravenous - complications Substance Abuse, Intravenous - epidemiology Vascular diseases and vascular malformations of the nervous system Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study |
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