TY - JOUR
T1 - Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy
T2 - Collaborative Analysis of Cohorts of HIV-1-Infected Patients
AU - Antiretroviral Therapy Cohort Collaboration
AU - Sterne, Jonathan A.C.
AU - May, Margaret
AU - Sabin, Caroline
AU - Phillips, Andrew
AU - Costagliola, Dominique
AU - Chêne, Geneviève
AU - Justice, Amy C.
AU - De Wolf, Frank
AU - Hogg, Robert
AU - Battegay, Manuel
AU - Monforte, Antonella D.Arminio
AU - Fa, Gerdtkenheuer
AU - Staszewski, Schlomo
AU - Gill, John
AU - Egger, Matthias
AU - Casabona, Jordi
AU - Dabis, Francxois
AU - Kitahata, Mari
AU - Leport, Catherine
AU - Lundgren, Jens
AU - Reiss, Peter
AU - Saag, Michael
AU - Weller, Ian
AU - Beckthold, Brenda
AU - Yip, Benita
AU - Dauer, Brenda
AU - Fusco, Jennifer
AU - Lanoy, Emilie
AU - Rickenbach, Martin
AU - Lavignolle, Valerie
AU - Van Sighem, Ard
AU - Pereira, Edwige
AU - Pezzotti, Patrizio
AU - Schmeisser, Norbert
AU - Billaud, E.
AU - Boué, F.
AU - Duval, X.
AU - Duvivier, C.
AU - Enel, P.
AU - Fournier, S.
AU - Gasnault, J.
AU - Gaud, C.
AU - Gilquin, J.
AU - Grabar, S.
AU - Khuong, M. A.
AU - Lang, J. M.
AU - Mary-Krause, M.
AU - Matheron, S.
AU - Yust, I.
AU - Turner, D.
N1 - Publisher Copyright:
Copyright © 2007 by Lippincott Williams & Wilkins.
PY - 2007/12/1
Y1 - 2007/12/1
N2 - Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/μL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.
AB - Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/μL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.
KW - AIDS
KW - CD4 counts
KW - HIV
KW - Highly active antiretroviral therapy
KW - Prognosis
KW - Substance abuse (intravenous)
UR - http://www.scopus.com/inward/record.url?scp=36549004647&partnerID=8YFLogxK
U2 - 10.1097/QAI.0b013e31815b7dba
DO - 10.1097/QAI.0b013e31815b7dba
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 18043315
AN - SCOPUS:36549004647
SN - 1525-4135
VL - 46
SP - 607
EP - 615
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
IS - 5
ER -