ATHENA data at the HIV Drug Therapy conference

The HIV Drug Therapy conference was held in Glasgow from 28 through to 31 October. At the meeting, two presentations involved data from Stichting HIV Monitoring’s ATHENA cohort.

The first oral presentation, given by SHM researcher Ferdinand Wit, focused on the relationship between multimorbidity and mortality within the ATHENA cohort from 2000 through to 2017. Multimorbidity was defined as the total number of comorbidities with which a patient was known at a particular moment. These included cardiovascular conditions, stroke, non-aids-related cancers, chronic kidney failure, obesity, and hypertension. Multimorbidity was found to be increasingly common in the ATHENA population, particularly among patients over the age of 50. The prevalence of multimorbidity was similar in older men and women, but higher in younger women than in young men. The latter appears to be due to the higher prevalence of obesity among young women. Multimorbidity was also found to be strongly associated with an increased risk of death. An interesting observation was that women without comorbidities had a statistically significant lower risk of death than men without comorbidities, but the risk of death in women increased more sharply with each additional comorbidity than in men, and at 3 and 4 comorbidities, women had a statistically significant higher risk of death than men with the equivalent number of comorbidities. The increased risk of death was most marked among women who had been treated with mono and dual nucleoside analogue reverse transcriptase inhibitors during the 1980s and 1990s. No other determinants could be found for the increased risk of death in women with multimorbidity.

Source: F Wit, M van der Valk, J Gisolf, et al. Multimorbidity and risk of death differs by gender in people living with HIV in the Netherlands: the ATHENA cohort study. Journal of the International AIDS Society 2018,21(S8):e25187, abstract O115.

In the second oral presentation, Flaminia Olearo of the Swiss HIV Cohort study discussed the relationship between the M184V/I mutation and the risk of virological failure associated with treatment with abacavir/lamivudine/dolutegravir. This was a multi-cohort analysis, that included data from the ATHENA cohort, in addition to that from four other cohorts. The study examined whether, during the period 2012 to 2016, pre-treated patients who were being treated with abacavir/lamivudine/dolutegravir had a higher risk of virological failure if they had the M184V/I mutation. Virological failure was defined as 2 consecutive viral load measurements above 50 copies/ml. In total, 1,626 patients were included, 137 of whom had the M184V/I mutation, and the average duration of follow up was 289 days. The study concluded that virological failure was more common in patients with the mutation than in those without.  

Source: F Olearo, H Nguyen, F Bonnet, et al. The impact of M184V/I mutation on the efficacy ofabacavir/lamivudine/dolutegravir regimens prescribed intreatment-experienced patients. Journal of the International AIDS Society 2018,21(S8):e25187, abstract O214.