ArticleOpen forum infectious diseases2026
Switching to Integrase Inhibitors and Cardiovascular Disease Risk in Treatment-Experienced People With HIV: A Sequential Target Trial Emulation in the Swiss HIV Cohort Study.
Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Integrase strand transfer inhibitors (INSTIs) are highly effective components of antiretroviral therapy for HIV. Recent studies suggest increased cardiovascular disease (CVD) risk after INSTI initiation, but findings remain inconsistent. The Swiss HIV Cohort Study is nationally representative, collects high-quality data, and provides an ideal setting for independent evaluation using causal methods, avoiding participant overlap in multicountry HIV-cohort consortiums. Methods: We emulated sequential target trials from November 2011 to September 2025 to estimate the effect of switching from non-INSTI to INSTI-based treatment on 6-year CVD risk among treatment-experienced people with HIV. Eligible participants were ≥18 years old, INSTI-naive, virally suppressed, and without CVD history. For each trial, participants were assigned to remain on non-INSTI or switch to INSTI. Intention-to-treat (ITT) and per-protocol (PP) effects were estimated using pooled logistic regression with baseline adjustment (ITT) and inverse probability weighting (PP). Results: Among 8815 individuals contributing 539 017 person-trials, 5750 switched to INSTI, and 507 CVD events occurred. In ITT analyses, the adjusted risk ratio for switching versus remaining on non-INSTI was 1.34 (95% confidence interval 1.03-1.69) after 1 year, and 1.03 (0.88-1.16) after 6 years. Absolute risk differences were small, ranging from 0.20 percentage points (0.02-0.37) after 1 year to 0.13 (-0.49 to 0.58) after 6 years. Per-protocol estimates were similar. Conclusions: Switching to INSTI-based treatment did not substantially increase long-term CVD risk in treatment-experienced individuals with well-controlled HIV. The early increase in absolute risk was small and was not expected to be clinically meaningful. This further contextualizes results from multicountry analyses.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.