analysis of this large cohort found no increased risk of MI
for people taking abacavir. This contrasts with previous analyses
from the D:A:D cohort and the SMART study, but confirms findings
from a GlaxoSmithKline analysis and others. As with other
studies, the absolute number of MIs in this study was found
to be small.
are two important notes about this study. First, a relatively
high percentage of participants (20%) were on unboosted PIs,
compared to 29% on boosted PIs. Second, a low percentage (34%)
were taking tenofovir
(Viread, also in the Truvada
coformulations). Neither of these accurately reflect current
prescribing trends for initial ART.
regimens are considered alternatives in the Department of
Health and Human Services (DHHS) federal HIV treatment guidelines.
This is due in part to findings from D:A:D and elsewhere of
an increased risk of MI with abacavir use. This study adds
to the body of research finding no such increased risk, and
is likely to add to the ongoing controversy around this important
affiliations: Center for Biostatistics in AIDS Research, Department
of Biostatistics, Harvard School of Public Health, Boston,
MA; Division of Infectious Disease, University of California,
San Diego, CA; Division of Infectious Diseases, Ohio State
University, Columbus, OH; School of Medicine, University of
Washington, Seattle, WA; Social & Scientific Systems,
Silver Spring, MD.
Ribaudo, CA Benson, Y Zheng, et al. No Risk of Myocardial
Infarction Associated With Initial Antiretroviral Treatment
Containing Abacavir: Short and Long-Term Results from ACTG
A5001/ALLRT. Clinical Infectious Diseases 52(7):929-940
full text). April 1, 2011.