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Conference
"Nucleoside Analogue Spring 2008 Update - Part 1" Dr. Jaime Hernandez (biography) English - 2008-04-25 - 26 minutes
(45 slides)
Summary : Dr. Hernandez compares the results of three clinical studies conducted by different research teams in order to determine whether the risk of myocardial infarction is increased in patients receiving treatment with HAART.
Dr. Hernandez first presents the results of an observational study from the Data Collection on Adverse Events of Anti-HIV Drugs (DAD), which are based on assessment of a cohort of 33,347 patients between 1999 and 2006, most of whom are European. This study found an association between the recent use of ABC and ddI and an increased risk of myocardial infarction.
Next, Dr. Hernandez takes a look at the literature and reviews a publication from the Veteran's Affair group in the United States, which consists of a retrospective study conducted on 41,213 patients between 1993 and 2003, and presents data sets that, compared to those obtained in the DAD study, are of older patients and contain more patients of black race. This publication concluded that there is no evidence of increased risk of cardiovascular events associated with long-term use of HAART.
Because the DAD's findings were unexpected and no explanation was provided for the results, Dr. Hernandez next takes a look at possible biologic mechanisms of Abacavir, but finds no causative factors either through the review of preclinical toxicology data or of clinical data with patients.
Finally, Dr. Hernandez reviews his group's past clinical trials, which involve a total of 14,680 patients between 1995 and 2007 and finds that he is unable to replicate the findings of the DAD.
Thus, Dr. Hernandez concludes that there is currently not enough information to indicate an association between HAART medication and an increased risk of myocardial infarction.
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