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Session 91 Poster Session Cardiovascular Disease Risk Session Time: 4:30-6:30 pm Room 4E-F

698-T. Protease Inhibitor Use and Adverse Cardiovascular Outcomes in Ambulatory HIV Patients S. Holmberg*1, A. Moorman1, T. Tong1, D. Ward2, K. Wood3, A. E. Greenberg1, and R. S. Janssen1 for the HIV Outpatient Study (HOPS) Investigators4 1CDC, Atlanta, GA; 2Dupont Circle Physicians Group, Washington, DC; 3Cerner Corp., Vienna, VA; and 48 U.S. cities Background: Protease inhibitor drugs (Pis) for HIV have been linked to hyperlipidemia, insulin resistance, and other risk factors for cardiovascular disease. Methods: We compared data to determine if the rate of myocardial infarction (MI), angina, or cerebrovascular accidents (CVAs) is increased in HIV-infected patients seen in a prospective cohort study (the HOPS) during visits to 9 HIV clinics nationwide between January 1993 and January 2001. Results: Incidence of MIs significantly increased in this cohort after the introduction of PI drugs in 1996 (linear regression, p= 0.0124). 13 of 3013 patient taking PI drugs but only 2 of 2663 patients who did not take these drugs had an MI (unadjusted OR = 5.77; 95% CI 1.3, 25.6; p= 0.009). This strong association remained in multivariate models controlling for hypertension, smoking, diabetes, age, gender, and evidence of dyslipidemia (adjusted OR= 4.92; 95% CI 1.3, 32.3; p= 0.04). Angina and CVAs were not significantly increased in those taking compared to those not taking PI drugs OR = 3.10 [95% CI 0.64, 14.94] and OR= 0.38 [95% CI 0.10, 1.47], respectively. Conclusion: Although MIs occurred infrequently and usually in persons with other cardiovascular risk factors, protease inhibitor drug use was strongly associated with incident MIs in these ambulatory HIV patients.

©2002 9th Conference on Retroviruses and Opportunistic Infections