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Abacavir is associated with elevated risk for cardiovascular events in the REPRIEVE trial
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IAS AIDS 2024 July 20-26 Munich
Carl J. Fichtenbaum
This is an association, the study does at look at causation, but at this point the well has been poisoned because the drug is not used very much in USA, due to these sorts of cohort studies finding associations, which many said they adjusted but can you always adjust for everything. Did they adjust for those with prior risk factors (channeling) in individual PWH for abacavir who this received abacavir instead of TDF. Apparently REPRIEVE study exclude anyone with <60 GFR, kidney disease so that excludes channeling fir kidney disease?? I found it questionable that protease inhibitors were not associated with an effect on CVD events, DAD cohort I believe found PIs associated with CVD. There have been many studies with mixed results on whether ABC is associated with CVD, there has not been a firm conclusion on a mechanism although some studies have found one, but I think they have been mixed results. One French cohort found after adjusting for substance abuse history there was no association. Jules
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