Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy
To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV). Prospective cohort study of patients with AIDS, conducted from 1998 through 2003. One thousand five hundred eighty-three patie...
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| Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 2005-05, Vol.112 (5), p.771-779 |
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| container_title | Ophthalmology (Rochester, Minn.) |
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| creator | Jabs, Douglas A. Holbrook, Janet T. Van Natta, Mark L. Clark, Rebecca Jacobson, Mark A. Kempen, John H. Murphy, Robert L. |
| description | To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV).
Prospective cohort study of patients with AIDS, conducted from 1998 through 2003.
One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis.
Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data.
Mortality.
The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100
000 copies/ml vs. |
| doi_str_mv | 10.1016/j.ophtha.2004.10.049 |
| format | Article |
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Prospective cohort study of patients with AIDS, conducted from 1998 through 2003.
One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis.
Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data.
Mortality.
The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100
000 copies/ml vs. <400 copies/ml;
P<0.0001), lower CD4+ T-cell count at enrollment (RR = 3.8 for CD4+ T cell count 0–49 cells/μl vs. ≥200 cells/μl;
P<0.0001), CMV viral load ≥400 copies/ml (RR = 1.9;
P = 0.002), lower hemoglobin (RR = 1.7 for hemoglobin <10 g/dl;
P = 0.009), a history of cryptococcal meningitis (RR = 1.7;
P = 0.02), CMV retinitis (RR = 1.6;
P = 0.0002), and Karnofsky score ≤80 (RR = 1.4;
P = 0.008).
In the era of HAART, CMV disease as manifested by CMV retinitis and a detectable CMV viral load were associated with an increased risk for mortality, even after adjusting for demographic, treatment, immunologic, and HIV virologic factors.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2004.10.049</identifier><identifier>PMID: 15878056</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acquired Immunodeficiency Syndrome - mortality ; Adult ; Antiretroviral Therapy, Highly Active - mortality ; Biological and medical sciences ; Cause of Death ; CD4 Lymphocyte Count ; Cryptococcus ; Cytomegalovirus ; Cytomegalovirus Retinitis - mortality ; Female ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Prospective Studies ; Risk Factors ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load</subject><ispartof>Ophthalmology (Rochester, Minn.), 2005-05, Vol.112 (5), p.771-779</ispartof><rights>2005 American Academy of Ophthalmology</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-76dde1558c59851e3f0b930f25c3a6fb6f5aee718a553dae96cde793f7bc4d633</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0161642004019128$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16765079$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15878056$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jabs, Douglas A.</creatorcontrib><creatorcontrib>Holbrook, Janet T.</creatorcontrib><creatorcontrib>Van Natta, Mark L.</creatorcontrib><creatorcontrib>Clark, Rebecca</creatorcontrib><creatorcontrib>Jacobson, Mark A.</creatorcontrib><creatorcontrib>Kempen, John H.</creatorcontrib><creatorcontrib>Murphy, Robert L.</creatorcontrib><creatorcontrib>Studies of Ocular Complications of AIDS Research Group</creatorcontrib><title>Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV).
Prospective cohort study of patients with AIDS, conducted from 1998 through 2003.
One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis.
Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data.
Mortality.
The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100
000 copies/ml vs. <400 copies/ml;
P<0.0001), lower CD4+ T-cell count at enrollment (RR = 3.8 for CD4+ T cell count 0–49 cells/μl vs. ≥200 cells/μl;
P<0.0001), CMV viral load ≥400 copies/ml (RR = 1.9;
P = 0.002), lower hemoglobin (RR = 1.7 for hemoglobin <10 g/dl;
P = 0.009), a history of cryptococcal meningitis (RR = 1.7;
P = 0.02), CMV retinitis (RR = 1.6;
P = 0.0002), and Karnofsky score ≤80 (RR = 1.4;
P = 0.008).
In the era of HAART, CMV disease as manifested by CMV retinitis and a detectable CMV viral load were associated with an increased risk for mortality, even after adjusting for demographic, treatment, immunologic, and HIV virologic factors.</description><subject>Acquired Immunodeficiency Syndrome - mortality</subject><subject>Adult</subject><subject>Antiretroviral Therapy, Highly Active - mortality</subject><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>CD4 Lymphocyte Count</subject><subject>Cryptococcus</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus Retinitis - mortality</subject><subject>Female</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral Load</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9rGzEQxUVIadyk3yAEXdLbutLq3-6lYNKkCaS0pOlZyNpRVu565Uqyi799tdiQW3saePzmMfMeQpeUzCmh8uNqHjZ97s28JoQXaU54e4JmVPC24oqyUzQrGK0kr8kZepfSihAiJeNv0RkVjWqIkDNkn3z6he-MzSEm7ELEX0PMZvB5j_2Iv5vsYcwJ__G5x4uHzz8mNfeAb6PBweF7_9IPe7yw2e8AL8bsI-QYdj6aAT_3EM1mf4HeODMkeH-c5-jn3e3zzX31-O3Lw83isbK8prlSsuuACtFY0TaCAnNk2TLiamGZkW4pnTAAijZGCNYZaKXtQLXMqaXlnWTsHH04-G5i-L2FlPXaJwvDYEYI26Rl-Vlx9X-wJg0jrBYF5AfQxpBSBKc30a9N3GtK9NSCXulDC3pqYVJLC2Xt6ui_Xa6he106xl6A6yNgkjWDi2a0Pr1yUklB1GT06cBBiW3nIepkSx8WuhKzzboL_t-X_AUlKqd0</recordid><startdate>20050501</startdate><enddate>20050501</enddate><creator>Jabs, Douglas A.</creator><creator>Holbrook, Janet T.</creator><creator>Van Natta, Mark L.</creator><creator>Clark, Rebecca</creator><creator>Jacobson, Mark A.</creator><creator>Kempen, John H.</creator><creator>Murphy, Robert L.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>20050501</creationdate><title>Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy</title><author>Jabs, Douglas A. ; Holbrook, Janet T. ; Van Natta, Mark L. ; Clark, Rebecca ; Jacobson, Mark A. ; Kempen, John H. ; Murphy, Robert L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-76dde1558c59851e3f0b930f25c3a6fb6f5aee718a553dae96cde793f7bc4d633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Acquired Immunodeficiency Syndrome - mortality</topic><topic>Adult</topic><topic>Antiretroviral Therapy, Highly Active - mortality</topic><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>CD4 Lymphocyte Count</topic><topic>Cryptococcus</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus Retinitis - mortality</topic><topic>Female</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jabs, Douglas A.</creatorcontrib><creatorcontrib>Holbrook, Janet T.</creatorcontrib><creatorcontrib>Van Natta, Mark L.</creatorcontrib><creatorcontrib>Clark, Rebecca</creatorcontrib><creatorcontrib>Jacobson, Mark A.</creatorcontrib><creatorcontrib>Kempen, John H.</creatorcontrib><creatorcontrib>Murphy, Robert L.</creatorcontrib><creatorcontrib>Studies of Ocular Complications of AIDS Research Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jabs, Douglas A.</au><au>Holbrook, Janet T.</au><au>Van Natta, Mark L.</au><au>Clark, Rebecca</au><au>Jacobson, Mark A.</au><au>Kempen, John H.</au><au>Murphy, Robert L.</au><aucorp>Studies of Ocular Complications of AIDS Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2005-05-01</date><risdate>2005</risdate><volume>112</volume><issue>5</issue><spage>771</spage><epage>779</epage><pages>771-779</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract>To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV).
Prospective cohort study of patients with AIDS, conducted from 1998 through 2003.
One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis.
Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data.
Mortality.
The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100
000 copies/ml vs. <400 copies/ml;
P<0.0001), lower CD4+ T-cell count at enrollment (RR = 3.8 for CD4+ T cell count 0–49 cells/μl vs. ≥200 cells/μl;
P<0.0001), CMV viral load ≥400 copies/ml (RR = 1.9;
P = 0.002), lower hemoglobin (RR = 1.7 for hemoglobin <10 g/dl;
P = 0.009), a history of cryptococcal meningitis (RR = 1.7;
P = 0.02), CMV retinitis (RR = 1.6;
P = 0.0002), and Karnofsky score ≤80 (RR = 1.4;
P = 0.008).
In the era of HAART, CMV disease as manifested by CMV retinitis and a detectable CMV viral load were associated with an increased risk for mortality, even after adjusting for demographic, treatment, immunologic, and HIV virologic factors.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15878056</pmid><doi>10.1016/j.ophtha.2004.10.049</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0161-6420 |
| ispartof | Ophthalmology (Rochester, Minn.), 2005-05, Vol.112 (5), p.771-779 |
| issn | 0161-6420 1549-4713 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acquired Immunodeficiency Syndrome - mortality Adult Antiretroviral Therapy, Highly Active - mortality Biological and medical sciences Cause of Death CD4 Lymphocyte Count Cryptococcus Cytomegalovirus Cytomegalovirus Retinitis - mortality Female Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Middle Aged Multivariate Analysis Prospective Studies Risk Factors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral Load |
| title | Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy |
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