Skip Navigation LinksHome > February 2010 - Volume 23 - Issue 1 > Abacavir and cardiovascular risk
Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0b013e328334fe84
HIV infection and AIDS: Edited by Martin Fisher

Abacavir and cardiovascular risk

Behrens, Georg MNa; Reiss, Peterb

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Abstract

Purpose of review: This review focuses on current studies addressing the association of abacavir (ABC) therapy and myocardial risk in HIV-infected patients, discusses potential pathogenetic mechanisms, and suggests a preliminary algorithm for decision making regarding ABC therapy in daily clinical practise.

Recent findings: The D:A:D study was the first to reveal an increased rate of myocardial infarction in patients recently treated with ABC. Subsequent analyses of both cohort studies as well as prospective randomized clinical trials largely confirmed this association. Although these studies varied considerably by design and their ability to control for confounders, they provide early support that ABC therapy can increase the risk for cardiovascular disease. The pathogenesis of this association remains elusive. Preliminary cross-sectional studies suggest the involvement of inflammation associated with ABC.

Conclusion: Prospective studies are required to provide additional evidence for the association of ABC therapy and cardiovascular events. In individual patients with underlying high cardiovascular risk, replacement of ABC may be considered, if it can be substituted by alternative equally effective treatment.

© 2010 Lippincott Williams & Wilkins, Inc.

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