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Increased risk of abdominal wall hernia associated with combination anti-retroviral therapy in HIV-infected patients-results from a Swedish cohort-study

Sundstrom, Anders; Mortimer, Orjan; Akerlund, Borje; Karlsson, Anders; Flamholc, Leo LU ; Hakangard, Camilla; Granholm, Helena; Persson, Ingemar and Morfeldt, Linda (2010) In Pharmacoepidemiology and Drug Safety 19(5). p.465-473
Abstract
Purpose To determine if anti-retroviral therapy (ART) in HIV-infected patients is associated with an increased risk for development of abdominal wall hernia. Methods A cohort study of 1072 HIV-infected patients in Sweden. Information was collected by questionnaires to patients and treating physicians, chart reviews by study physicians and regular blood tests for metabolic disorders. Adjusted relative risks were estimated by Cox proportional hazards models. Results Sixty-three patients (5.9%) developed abdominal wall hernia during the study period, 34 inguinal and 29 midline. Compared to the male general population, inguinal hernia was twice as common in the male study population, standardized incidence ratio (SIR) 2.0 (95% confidence... (More)
Purpose To determine if anti-retroviral therapy (ART) in HIV-infected patients is associated with an increased risk for development of abdominal wall hernia. Methods A cohort study of 1072 HIV-infected patients in Sweden. Information was collected by questionnaires to patients and treating physicians, chart reviews by study physicians and regular blood tests for metabolic disorders. Adjusted relative risks were estimated by Cox proportional hazards models. Results Sixty-three patients (5.9%) developed abdominal wall hernia during the study period, 34 inguinal and 29 midline. Compared to the male general population, inguinal hernia was twice as common in the male study population, standardized incidence ratio (SIR) 2.0 (95% confidence interval (CI) 1.4-2.8). An increased incidence rate of abdominal wall hernia was found in patients exposed to ART, 11.3 per 1000 person-years (PY) compared with therapy naives, 2.1 per 1000 PY. When adjusting for confounding risk-factors, ART containing protease inhibitors (Pis) during the 2nd and 3rd year of treatment was associated with the development of midline hernia with a hazard ratio (HR) of 10.7 (95%CI 1.3-85.7), and of inguinal hernia with an HR of 4.4 (95%CI 1.1-16.6). Other independent risk factors were age and diabetes/impaired fasting glucose for midline hernia, and age and a previous diagnosis of AIDS for inguinal hernia. Conclusions We found an increased risk of developing abdominal wall hernia associated with PI-containing ART. The size of the study population did not permit any conclusions regarding non-PI-containing ART. Copyright (C) 2010 John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
study, cohort, midline hernia, inguinal hernia, HIV, anti-retroviral therapy, adverse drug reaction
in
Pharmacoepidemiology and Drug Safety
volume
19
issue
5
pages
465 - 473
publisher
John Wiley & Sons
external identifiers
  • wos:000277987600006
  • scopus:77952778759
ISSN
1053-8569
DOI
10.1002/pds.1922
language
English
LU publication?
yes
id
07f2d30e-135b-44b9-bee1-160cb609801a (old id 1616686)
date added to LUP
2010-06-22 14:08:29
date last changed
2018-05-29 11:07:24
@article{07f2d30e-135b-44b9-bee1-160cb609801a,
  abstract     = {Purpose To determine if anti-retroviral therapy (ART) in HIV-infected patients is associated with an increased risk for development of abdominal wall hernia. Methods A cohort study of 1072 HIV-infected patients in Sweden. Information was collected by questionnaires to patients and treating physicians, chart reviews by study physicians and regular blood tests for metabolic disorders. Adjusted relative risks were estimated by Cox proportional hazards models. Results Sixty-three patients (5.9%) developed abdominal wall hernia during the study period, 34 inguinal and 29 midline. Compared to the male general population, inguinal hernia was twice as common in the male study population, standardized incidence ratio (SIR) 2.0 (95% confidence interval (CI) 1.4-2.8). An increased incidence rate of abdominal wall hernia was found in patients exposed to ART, 11.3 per 1000 person-years (PY) compared with therapy naives, 2.1 per 1000 PY. When adjusting for confounding risk-factors, ART containing protease inhibitors (Pis) during the 2nd and 3rd year of treatment was associated with the development of midline hernia with a hazard ratio (HR) of 10.7 (95%CI 1.3-85.7), and of inguinal hernia with an HR of 4.4 (95%CI 1.1-16.6). Other independent risk factors were age and diabetes/impaired fasting glucose for midline hernia, and age and a previous diagnosis of AIDS for inguinal hernia. Conclusions We found an increased risk of developing abdominal wall hernia associated with PI-containing ART. The size of the study population did not permit any conclusions regarding non-PI-containing ART. Copyright (C) 2010 John Wiley & Sons, Ltd.},
  author       = {Sundstrom, Anders and Mortimer, Orjan and Akerlund, Borje and Karlsson, Anders and Flamholc, Leo and Hakangard, Camilla and Granholm, Helena and Persson, Ingemar and Morfeldt, Linda},
  issn         = {1053-8569},
  keyword      = {study,cohort,midline hernia,inguinal hernia,HIV,anti-retroviral therapy,adverse drug reaction},
  language     = {eng},
  number       = {5},
  pages        = {465--473},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Increased risk of abdominal wall hernia associated with combination anti-retroviral therapy in HIV-infected patients-results from a Swedish cohort-study},
  url          = {http://dx.doi.org/10.1002/pds.1922},
  volume       = {19},
  year         = {2010},
}