Current or previous use of the antiretroviral drug (ARV) abacavir was associated with an elevated risk of major adverse cardiovascular events (MACE) in people with HIV, according to an exploratory analysis from a large international clinical trial primarily funded by the National Institutes of Health (NIH). There was no elevated MACE risk for the other antiretroviral drugs included in the analysis. The findings will be presented at the 2024 International AIDS Conference (AIDS 2024) in Munich, Germany.
The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) enrolled 7,769 study participants with HIV from 12 countries that found daily use of a cholesterol-fighting statin drug reduced the risk of major adverse cardiovascular events, such as heart attacks and strokes by more than one third. The REPRIEVE study team also performed statistical analyses to assess whether select ARVs were associated with MACE risk among study participants, all of whom had low-to-moderate cardiovascular disease risk. The ARVs selected for analysis had previously been linked to cardiovascular risk and included abacavir, tenofovir, zidovudine, stavudine, and drugs from a class called protease inhibitors (PIs).
All were taken as part of multi-drug ART regimens. Overall, 22% of study participants reported prior exposure to abacavir, 86% to tenofovir, 49% to zidovudine or stavudine, and 47% to PIs. At study entry, 13% of participants were taking abacavir, 61% were taking tenofovir, 10% were taking.