Incident Hypertension with Antiretroviral Therapy in the OPERA Cohort

Purpose of the researchTo compare incident hypertension rates across antiretroviral therapy regimens among adults with HIV in routine clinical care in the US-based OPERA cohort.Major findingsThe hypertension incidence rate was 4.16 per 100 person-years (95% CI: 3.75, 4.61) among 3220 ART-naïve individuals, and 4.60 (95% CI: 3.99, 5.30) among 1442 ART-experienced individuals. There was no statistically significant difference in incident hypertension between regimens at the class-level (integrase inhibitor with/without tenofovir alafenamide (TAF), boosted protease inhibitor, and non-nucleoside reverse transcriptase inhibitor) nor the drug-level (dolutegravir three-drug regimen with/without TAF, dolutegravir/lamivudine, bictegravir/emtricitabine/TAF, and boosted darunavir with TAF three-drug regimen).ConclusionsIn this large cohort representing routine clinical care in the USA, classes of antiretrovirals and specific agent combinations with or without TAF were not statistically significantly associated with incident hypertension. Other factors are likely to be more important drivers of hypertension than antiretroviral therapy selection in people with HIV.