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| |  No Link Found Between Abacavir and Cardiovascular Disease Biomarkers: Presented at IAS By Charlene Laino CAPE TOWN, South Africa -- July 23, 2009 -- The use of abacavir plus lamivudine is not associated with significant changes in biomarkers of inflammation, coagulation, blood vessel dysfunction, or insulin resistance in otherwise healthy HIV-positive patients with suppressed viral loads. The findings “argue against the involvement of abacavir in any of these mechanisms” and do not support the higher risk of myocardial infarction observed in some recent cohort studies, said Esteban Martínez, MD, Infectious Diseases Unit, University of Barcelona, Barcelona Spain, on July 20 at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention. The researchers performed a retrospective analysis of data from the randomised controlled trial of the efficacy and safety of tenofovir plus emtricitabine versus abacavir plus lamivudine (BICOMBO study). The analysis involved a subset of 80 patients from the 335 patients who participated in the BICOMBO study. A total of 46 patients were treated with abacavir plus lamivudine and 34 patients with tenofovir and emtricitabine. Participants had been on antiretroviral therapy for an average of nearly 4 years. The researchers measured blood biomarkers associated with an increased risk of cardiovascular disease including C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), osteoprotegerin (OPG), adiponectin, interleukin (IL)-6, IL-10, tumour necrosis factor (TNF)-alpha, inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), selectin E and P, D-dimer, and insulin. At baseline, there were no significant differences in levels of any of the biomarkers between the 2 arms. After 48 weeks, changes in all biomarker levels “were relatively minor and were comparable for patients taking abacavir and those taking tenofovir,” Dr. Martinez reported. Specifically, the median 48-week percent changes in markers between the abacavir and tenofovir groups were: CRP (-3.9 vs 0.0), MCP-1 (5.9 vs 4.0), OPG (5.1 vs -2.8), adiponectin (-2.2 vs 15.4), ICAM-1 (6.6 vs 5.2), VCAM-1 (8.4 vs -2.0), selectin E (-0.4 vs 7.8), selectin P (4.6 vs 12.6), D-dimer (0.0 vs 0.0), and insulin (-2.5 vs 8.8; P =.12 for all comparisons). IL-6, IL-10, and TNF-alpha levels were undetectable for most patients at 48 weeks.
[Presentation title: No Evidence for Recent Abacavir/Lamivudine Use in Promoting Inflammation, Endothelial Dysfunction, Hypercoagulability, or Insulin Resistance in Virologically Suppressed HIV-Infected Patients: A Substudy of the BICOMBO Randomized Clinical Trial (ISRCTN61891868). Abstract MOAB203]
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