. 2022 Sep;23(8):895-910.

doi: 10.1111/hiv.13273. Epub 2022 Mar 1.

Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

Dathan M Byonanebye^{1

2}, Mark N Polizzotto¹, Bastian Neesgaard³, Mario Sarcletti⁴, Raimonda Matulionyte⁵, Dominique L Braun⁶, Antonella Castagna⁷, Stéphane de Wit⁸, Ferdinand Wit⁹, Eric Fontas¹⁰, Jörg Janne Vehreschild^{11

12}, Jan Vesterbacka¹³, Lauren Greenberg¹⁴, Camilla Hatleberg³, Harmony Garges¹⁵, Joel Gallant¹⁶, Alain Volny Anne¹⁷, Angela Öllinger³, Iwona Mozer-Lisewska¹⁸, Bernard Surial¹⁹, Vincenzo Spagnuolo⁷, Coca Necsoi⁸, Marc van der Valk^{9

20}, Amanda Mocroft^{3

14}, Matthew Law¹, Lene Ryom³, Kathy Petoumenos¹; RESPOND study group

Collaborators, Affiliations

Collaborators

RESPOND study group:
M Hillebregt, N Rose, J Hutchinson, R Zangerle, H Appoyer, M Delforge, C Stephan, M Bucht, N Chkhartishvili, O Chokoshvili, C Mussini, V Borghi, C Pradier, K Dollet, C Caissotti, J Casabona, J M Miro, C Smith, F Lampe, M Johnson, F Burns, C Chaloner, A Lazzarin, A Poli, A Sönnerborg, K Falconer, V Svedhem, H Günthard, B Ledergerber, H Bucher, A Scherrer, J C Wasmuth, J Rockstroh, G Fätkenheuer, M Stecher, N Schulze, B Franke, Lene Ryom, J Rooney, I McNicholl, V Vannappagari, G Wandeler, J Lundgren, J Kowalska, D Raben, A Mocroft, L Peters, E D Williams, C Necsoi, A D'Arminio Monforte, A Bruguera, Nikos Dedes, Luis Mendao, J F Larsen, N Jaschinski, M L Jakobsen, T Bruun, A Bojesen, E V Hansen, A K Traytel, T W Elsing, D Kristensen, T Weide, L Bansi-Matharu, A Pelchen-Matthews

Affiliations

¹ Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
² School of Public Health, Makerere University, Kampala, Uganda.
³ CHIP, Centre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
⁴ Department of Dermatology, Venerology and Allergology, Medical University Innsbruck, Innsbruck, Austria.
⁵ Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.
⁶ Division of Infectious Diseases and Hospital Epidemiology, Switzerland Swiss HIV Cohort Study (SHCS), Institute of Medical Virology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁷ San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milano, Italy.
⁸ CHU Saint Pierre, Infectious Diseases, Université Libre de Bruxelles, Brussels, Belgium.
⁹ AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, HIV Monitoring Foundation, Amsterdam, The Netherlands.
¹⁰ Nice HIV Cohort, Université Côte d'Azur et Centre Hospitalier Universitaire, Nice, France.
¹¹ Medical Department 2, Hematology/Oncology, University Hospital of Frankfurt, Frankfurt, Germany.
¹² Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.
¹³ Swedish InfCare HIV Cohort, Karolinska University Hospital, Huddinge, Sweden.
¹⁴ Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
¹⁵ ViiV Healthcare, RTP, North Carolina, USA.
¹⁶ Gilead Sciences, Foster City, California, USA.
¹⁷ EATG European AIDS Treatment Group, Brussels, Belgium.
¹⁸ Poznan University of Medical Sciences, Poznan, Poland.
¹⁹ Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁰ Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 35233903
PMCID: PMC9545382
DOI: 10.1111/hiv.13273

Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

Dathan M Byonanebye et al. HIV Med. 2022 Sep.

. 2022 Sep;23(8):895-910.

doi: 10.1111/hiv.13273. Epub 2022 Mar 1.

Authors

Collaborators

RESPOND study group:
M Hillebregt, N Rose, J Hutchinson, R Zangerle, H Appoyer, M Delforge, C Stephan, M Bucht, N Chkhartishvili, O Chokoshvili, C Mussini, V Borghi, C Pradier, K Dollet, C Caissotti, J Casabona, J M Miro, C Smith, F Lampe, M Johnson, F Burns, C Chaloner, A Lazzarin, A Poli, A Sönnerborg, K Falconer, V Svedhem, H Günthard, B Ledergerber, H Bucher, A Scherrer, J C Wasmuth, J Rockstroh, G Fätkenheuer, M Stecher, N Schulze, B Franke, Lene Ryom, J Rooney, I McNicholl, V Vannappagari, G Wandeler, J Lundgren, J Kowalska, D Raben, A Mocroft, L Peters, E D Williams, C Necsoi, A D'Arminio Monforte, A Bruguera, Nikos Dedes, Luis Mendao, J F Larsen, N Jaschinski, M L Jakobsen, T Bruun, A Bojesen, E V Hansen, A K Traytel, T W Elsing, D Kristensen, T Weide, L Bansi-Matharu, A Pelchen-Matthews

Affiliations

¹ Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
² School of Public Health, Makerere University, Kampala, Uganda.
³ CHIP, Centre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
⁴ Department of Dermatology, Venerology and Allergology, Medical University Innsbruck, Innsbruck, Austria.
⁵ Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.
⁶ Division of Infectious Diseases and Hospital Epidemiology, Switzerland Swiss HIV Cohort Study (SHCS), Institute of Medical Virology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁷ San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milano, Italy.
⁸ CHU Saint Pierre, Infectious Diseases, Université Libre de Bruxelles, Brussels, Belgium.
⁹ AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, HIV Monitoring Foundation, Amsterdam, The Netherlands.
¹⁰ Nice HIV Cohort, Université Côte d'Azur et Centre Hospitalier Universitaire, Nice, France.
¹¹ Medical Department 2, Hematology/Oncology, University Hospital of Frankfurt, Frankfurt, Germany.
¹² Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.
¹³ Swedish InfCare HIV Cohort, Karolinska University Hospital, Huddinge, Sweden.
¹⁴ Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
¹⁵ ViiV Healthcare, RTP, North Carolina, USA.
¹⁶ Gilead Sciences, Foster City, California, USA.
¹⁷ EATG European AIDS Treatment Group, Brussels, Belgium.
¹⁸ Poznan University of Medical Sciences, Poznan, Poland.
¹⁹ Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁰ Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 35233903
PMCID: PMC9545382
DOI: 10.1111/hiv.13273

Abstract

Objective: To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts.

Methods: Eligible people with HIV were aged ≥18 years who initiated a new three-drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow-up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ≥140 mmHg and/or diastolic BP ≥90 mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART naïve or experienced at baseline.

Results: Overall, 4606 people living with HIV were eligible (INSTIs 3164, NNRTIs 807, PIs 635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113-130) mmHg, 78 (70-82) mmHg, and 43 (34-50) years, respectively. Over 8380.4 person-years (median follow-up 1.5 [IQR 1.0-2.7] years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person-years, 95% confidence interval [CI] 118.9-134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76; 95% CI 1.47-2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07; 95% CI 0.89-1.29). The results were similar when the analysis was stratified by ART status at baseline.

Conclusion: Although unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART-naïve and ART-experienced participants within RESPOND.

Keywords: HIV; antiretroviral agents; hypertension; integrase inhibitors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**FIGURE 1**
Incidence rate ratios of hypertension in participants receiving INSTI‐based regimens versus those on NNRTIs (a) or PIs (b) *Note*: The final multivariable model was adjusted for the nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone, age, ethnicity, sex, mode of transmission, calendar year, estimated glomerular filtration rate, smoking, body mass index, diabetes mellitus, prior AIDS, cardiovascular disease, hepatitis B and hepatitis C virus status, HIV RNA, nadir, and baseline CD4 counts, time since HIV diagnosis, baseline blood pressure and lipid levels, lipid‐lowering therapy, and prior ART (in the analysis for all people living with HIV). Abbreviations: ART, antiretroviral therapy; CI, confidence interval; INSTI, integrase strand transfer inhibitor; NNRTI, non‐nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; PLWH, people living with HIV

See this image and copyright information in PMC

References

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Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

Collaborators

Affiliations

Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical