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

• DOI: 10.1111/hiv.13273
• Publication Date: 2022-03-02T02:34:49Z
• Authors: Dathan M. Byonanebye; Mark N. Polizzotto; Bastian Neesgaard; Mario Sarcletti; Raimonda Matulionyte; Dominique L. Braun; Antonella Castagna; Stéphane de Wit; Ferdinand Wit; Eric Fontas; Jörg Janne Vehres...; Jan Vesterbacka; Lauren Greenberg; Camilla Hatleberg; Harmony Garges; Joel Gallant; Alain Volny Anne; Angela Öllinger; Iwona Mozer‐Lisewska; Bernard Surial; Vincenzo Spagnuolo; Coca Necsoi; Marc van der Valk; Amanda Mocroft; Matthew Law; Lene Ryom; Kathy Petoumenos
• Keywords: Adult; CLINICAL CARE; HIV ; antiretroviral agents ; hypertension ; integrase inhibitors; hypertension; Adolescent; Anti-HIV Agents; 610 Medicine & health; HIV Infections; Integrase Inhibitors; THERAPY; 03 medical and health sciences; 0302 clinical medicine; antiretroviral agents; HIV; hypertension; integrase inhibitors; Humans; HIV Integrase Inhibitors; PREDICTORS; POPULATION; RISK; Aged, 80 and over; INFECTED PATIENTS; Science & Technology; Incidence; HIV; ADULTS; Original Articles; 16. Peace & justice; antiretroviral agents; 3. Good health; PREVALENCE; TIME; Infectious Diseases; integrase inhibitors; Anti-Retroviral Agents; INCREASED BLOOD-PRESSURE; Hypertension; Reverse Transcriptase Inhibitors; Life Sciences & Biomedicine

AbstractObjectiveTo 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.MethodsEligible 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.ResultsOverall, 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.ConclusionAlthough 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.