Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy : Collaborative Analysis of Cohorts of HIV-1-Infected Patients
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. We analyzed data on 20,379 treatment-naive HIV-1-infected adults who started HAA...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2007-12, Vol.46 (5), p.607-615 |
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| description | 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.
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).
Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/microL (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).
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. |
| doi_str_mv | 10.1097/QAI.0b013e31815b7dba |
| format | Article |
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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).
Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/microL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/microL (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).
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.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e31815b7dba</identifier><identifier>PMID: 18043315</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; AIDS ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; CD4 Lymphocyte Count ; Drug therapy ; Europe - epidemiology ; Fundamental and applied biological sciences. Psychology ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - mortality ; HIV Infections - virology ; HIV-1 - isolation & purification ; Human viral diseases ; Humans ; Immune system ; Infectious diseases ; Medical prognosis ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; North America - epidemiology ; Prognosis ; Risk Factors ; Substance Abuse, Intravenous ; Survival Analysis ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Virology</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2007-12, Vol.46 (5), p.607-615</ispartof><rights>2008 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Dec 15, 2007</rights><rights>Copyright © 2007 by Lippincott Williams & Wilkins 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c366t-a4e672b2b1f62956d8ab084474f18da63df66199ef4dee95ea9e2320e50ec9023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19889448$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18043315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Antiretroviral Therapy Cohort Collaboration</creatorcontrib><title>Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy : Collaborative Analysis of Cohorts of HIV-1-Infected Patients</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>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.
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).
Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/microL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/microL (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).
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.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Drug therapy</subject><subject>Europe - epidemiology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - mortality</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - isolation & purification</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immune system</subject><subject>Infectious diseases</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>North America - epidemiology</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Substance Abuse, Intravenous</subject><subject>Survival Analysis</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Virology</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdktGK1DAUhoso7rr6BiJB8LJr0qRp4oUwDq5TWHDFUS9Dmp5Os3SS2SQzMC_m85lxi6te5UC-_z_n8J-ieEnwJcGyeftl0V7iDhMKlAhSd03f6UfFOZGMlY0Q7HGu66ouGaH1WfEsxluMCWdMPi3OiMCMUlKfFz_b7c6HpJ0B5Af0QUeYrAN0E_zG-ZisQVfaJB8i-mHTiFpnAuho3Qat7RbQV3tSts4mq5P17mSysptxOqKFSfYAaOGSDZCCP9igJ7QeIejdEb1DSz9NuvNBz5iejtHGk8HSj3mm3-Wq_V6SsnUDmAQ9uskwuBSfF08GPUV4Mb8Xxberj-vlqrz-_KldLq5LQzlPpWbAm6qrOjLwSta8F7rDgrGGDUT0mtN-4JxICQPrAWQNWkJFKww1BiNxRS-K9_e-u323hd7k3nkJtQt2q8NReW3Vvz_OjmrjD4py0dRcZoPXs0Hwd3uISd36fci7RlVRmuPgXGSI3UMm-BgDDH8aEKxOYasctvo_7Cx79fdwD6I53Qy8mQEdjZ6GkGO28YGTQuRrEfQXVTi4Ow</recordid><startdate>20071215</startdate><enddate>20071215</enddate><creator>Antiretroviral Therapy Cohort Collaboration</creator><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</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>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>5PM</scope></search><sort><creationdate>20071215</creationdate><title>Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy : Collaborative Analysis of Cohorts of HIV-1-Infected Patients</title></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-a4e672b2b1f62956d8ab084474f18da63df66199ef4dee95ea9e2320e50ec9023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>AIDS</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Drug therapy</topic><topic>Europe - epidemiology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - mortality</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - isolation & purification</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immune system</topic><topic>Infectious diseases</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>North America - epidemiology</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Substance Abuse, Intravenous</topic><topic>Survival Analysis</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Antiretroviral Therapy Cohort Collaboration</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>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><aucorp>Antiretroviral Therapy Cohort Collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy : Collaborative Analysis of Cohorts of HIV-1-Infected Patients</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2007-12-15</date><risdate>2007</risdate><volume>46</volume><issue>5</issue><spage>607</spage><epage>615</epage><pages>607-615</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>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.
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).
Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count <25 cells/microL had persistently higher progression rates than individuals with a baseline CD4 count >350 cells/microL (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).
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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18043315</pmid><doi>10.1097/QAI.0b013e31815b7dba</doi><tpages>9</tpages></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2007-12, Vol.46 (5), p.607-615 |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete; Free E- Journals |
| subjects | Acquired immune deficiency syndrome Adolescent Adult AIDS Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences CD4 Lymphocyte Count Drug therapy Europe - epidemiology Fundamental and applied biological sciences. Psychology HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - mortality HIV Infections - virology HIV-1 - isolation & purification Human viral diseases Humans Immune system Infectious diseases Medical prognosis Medical sciences Microbiology Middle Aged Miscellaneous North America - epidemiology Prognosis Risk Factors Substance Abuse, Intravenous Survival Analysis Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology |
| title | Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy : Collaborative Analysis of Cohorts of HIV-1-Infected Patients |
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