Titre
Hierarchical modeling gave plausible estimates of associations between metabolic syndrome and components of antiretroviral therapy.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Young, J.
Auteure/Auteur
Glass, T.R.
Auteure/Auteur
Bernasconi, E.
Auteure/Auteur
Rickenbach, M.
Auteure/Auteur
Furrer, H.
Auteure/Auteur
Hirschel, B.
Auteure/Auteur
Tarr, P.E.
Auteure/Auteur
Vernazza, P.
Auteure/Auteur
Battegay, M.
Auteure/Auteur
Bucher, H.C.
Auteure/Auteur
Contributrices/contributeurs
Battegay, M.
Bernasconi, E.
Böni, J.
Bucher, HC.
Bürgisser, P.
Cattacin, S.
Cavassini, M.
Dubs, R.
Egger, M.
Elzi, L.
Erb, P.
Fischer, M.
Flepp, M.
Fontana, A.
Francioli, P.
Furrer, H.
Gorgievski, M.
Günthard, H.
Hirsch, H.
Hirschel, B.
Hösli, I.
Kahlert, Ch.
Kaiser, L.
Karrer, U.
Kind, C.
Klimkait, T.
Ledergerber, B.
Martinetti, G.
Martinez, B.
Müller, N.
Nadal, D.
Opravil, M.
Paccaud, F.
Pantaleo, G.
Rickenbach, M.
Rudin, C.
Schmid, P.
Schultze, D.
Schüpbach, J.
Speck, R.
Taffé, P.
Tarr, P.
Telenti, A.
Trkola, A.
Vernazza, P.
Weber, R.
Yerly, S.
Groupes de travail
Swiss HIV Cohort Study
Liens vers les personnes
Liens vers les unités
ISSN
1878-5921
Statut éditorial
Publié
Date de publication
2009
Volume
62
Numéro
6
Première page
632
Dernière page/numéro d’article
641
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
OBJECTIVE: Hierarchical modeling has been proposed as a solution to the multiple exposure problem. We estimate associations between metabolic syndrome and different components of antiretroviral therapy using both conventional and hierarchical models.
STUDY DESIGN AND SETTING: We use discrete time survival analysis to estimate the association between metabolic syndrome and cumulative exposure to 16 antiretrovirals from four drug classes. We fit a hierarchical model where the drug class provides a prior model of the association between metabolic syndrome and exposure to each antiretroviral.
RESULTS: One thousand two hundred and eighteen patients were followed for a median of 27 months, with 242 cases of metabolic syndrome (20%) at a rate of 7.5 cases per 100 patient years. Metabolic syndrome was more likely to develop in patients exposed to stavudine, but was less likely to develop in those exposed to atazanavir. The estimate for exposure to atazanavir increased from hazard ratio of 0.06 per 6 months' use in the conventional model to 0.37 in the hierarchical model (or from 0.57 to 0.81 when using spline-based covariate adjustment).
CONCLUSION: These results are consistent with trials that show the disadvantage of stavudine and advantage of atazanavir relative to other drugs in their respective classes. The hierarchical model gave more plausible results than the equivalent conventional model.
STUDY DESIGN AND SETTING: We use discrete time survival analysis to estimate the association between metabolic syndrome and cumulative exposure to 16 antiretrovirals from four drug classes. We fit a hierarchical model where the drug class provides a prior model of the association between metabolic syndrome and exposure to each antiretroviral.
RESULTS: One thousand two hundred and eighteen patients were followed for a median of 27 months, with 242 cases of metabolic syndrome (20%) at a rate of 7.5 cases per 100 patient years. Metabolic syndrome was more likely to develop in patients exposed to stavudine, but was less likely to develop in those exposed to atazanavir. The estimate for exposure to atazanavir increased from hazard ratio of 0.06 per 6 months' use in the conventional model to 0.37 in the hierarchical model (or from 0.57 to 0.81 when using spline-based covariate adjustment).
CONCLUSION: These results are consistent with trials that show the disadvantage of stavudine and advantage of atazanavir relative to other drugs in their respective classes. The hierarchical model gave more plausible results than the equivalent conventional model.
Sujets
PID Serval
serval:BIB_DADAFC5F4F9A
PMID
Date de création
2009-02-26T09:21:20.594Z
Date de création dans IRIS
2025-05-21T00:58:49Z