RESULTS
PWH, cardiovascular disease, CVD, strokes
EVENT, CARDIOVASCULAR DISEASE, CVD, MAY, MYOCARDIAL INFARCTIONS, EVENTS, CARDIOVASCULAR DISEASE, STROKES
Of 13 767 SHCS participants with available follow-up after May 2008, 6027 started their first ART regimen after that date. After excluding 24 individuals with an unknown ART regimen, 7 individuals who received maraviroc as part of their initial ART regimen, and 634 individuals with an undetectable HIV viral load at ART start, the study population included 5362 PWH (Use of integrase strand transfer inhibitor (INSTI) as initial antiretroviral treatment over time. Representation of the proportion of treatment-naïve individuals who received INSTI-based or other antiretroviral therapy (ART) combinations as first-line treatment in the Swiss HIV Cohort Study (SHCS) over time. After INSTIs were recommended as the preferred initial regimens in major treatment guidelines (vertical dashed line), uptake of INSTIs rapidly increased: in 2021, 96% of individuals starting ART received INSTI compared with 4% who received other ART.Characteristics of Study Participants at ART StartAbbreviations: ART, antiretroviral therapy; BMI, body mass index; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; INSTI, integrase strand transfer inhibitor; IQR, interquartile range; MSM, men who have sex with men; PWID, persons who inject drugs.Within a median follow-up of 4.9 years (IQR, 2.4–7.4), 116 CVD events occurred: 37 myocardial infarctions (31.9%), 36 strokes (31.0%), and 43 invasive cardiovascular procedures (37.1%, Cumulative incidence of cardiovascular disease (CVD) events after starting antiretroviral therapy. (Cardiovascular Disease Event Risks After Starting Antiretroviral TherapyAbbreviations: ART, antiretroviral therapy; CVD, cardiovascular disease; INSTI, integrase strand transfer inhibitor.Adjusted for confounding and informative censoring (refer to Methods for a detailed list of covariates).The impact of starting INSTIs compared with other ART was consistent across age groups (≥65 years vs < 65 years, Impact of INSTI on cardiovascular disease risk overall and by prespecified subgroups. The forest plot shows hazard ratios (95% confidence intervals) adjusted for confounders and informative censoring (see Methods section for a full list of covariates). ABC, abacavir; INST, integrase strand transfer inhibitor.