Current hemoglobin levels are more predictive of disease progression than hemoglobin measured at baseline in patients receiving antiretroviral treatment for HIV type 1 infection
The role of hemoglobin levels as an independent prognostic marker of progression to AIDS and/or death in HIV-infected patients starting combination antiretroviral therapy (cART) was investigated. A total of 2,579 patients from the EuroSIDA cohort with hemoglobin, CD4 cell count, and HIV RNA viral lo...
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| Veröffentlicht in: | AIDS research and human retroviruses 2007-10, Vol.23 (10), p.1183-1188 |
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| container_title | AIDS research and human retroviruses |
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| creator | Kowalska, Justyna D Mocroft, Amanda Blaxhult, Anders Colebunders, Robert van Lunzen, Jan Podlekareva, Daria Hansen, Ann-Brit Eg Machala, Ladislav Yust, Israel Benfield, Thomas |
| description | The role of hemoglobin levels as an independent prognostic marker of progression to AIDS and/or death in HIV-infected patients starting combination antiretroviral therapy (cART) was investigated. A total of 2,579 patients from the EuroSIDA cohort with hemoglobin, CD4 cell count, and HIV RNA viral load measured 6 months prior to starting cART was included in the analyses. Anemia was defined as mild ( |
| doi_str_mv | 10.1089/aid.2006.0292 |
| format | Article |
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A total of 2,579 patients from the EuroSIDA cohort with hemoglobin, CD4 cell count, and HIV RNA viral load measured 6 months prior to starting cART was included in the analyses. Anemia was defined as mild (<or=14 g/dl males, <or=12 g/dl females) and severe (<8 g/dl both genders). Poisson regression was used to determine factors related to clinical progression (new AIDS/death). Hemoglobin levels increased by a median of +0.48 g/dl (IQR -0.4 to +1.3) in the first year of cART. During 14,272 person years of follow-up (PYFU) there were 505 new AIDS/deaths. Of the patients 304 (11.8%) developed mild and 19 severe anemia (0.7%). In multivariate analysis baseline hemoglobin was significantly associated with progression to AIDS/death after starting cART with an IRR of 1.07 per 1 g/dl lower (95% CI 1.01-1.13; p = 0.023). When hemoglobin was fitted as a time-updated variable the IRR increased to 1.36 per 1 g/dl lower (95% CI 1.30-1.42; p < 0.001). Starting cART was associated with an increase in hemoglobin levels. Lower hemoglobin values, particularly the latest measured, were associated with an increased risk of disease progression.</description><identifier>ISSN: 0889-2229</identifier><identifier>EISSN: 1931-8405</identifier><identifier>DOI: 10.1089/aid.2006.0292</identifier><identifier>PMID: 17961102</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adult ; AIDS/HIV ; Anemia ; Anti-HIV Agents - therapeutic use ; Antiviral agents ; CD4 Lymphocyte Count ; Cohort Studies ; Complications and side effects ; Development and progression ; Disease Progression ; Dosage and administration ; Drug therapy ; Female ; Health aspects ; Hemoglobin ; Hemoglobins - analysis ; HIV infection ; HIV Infections - blood ; HIV Infections - drug therapy ; HIV Infections - physiopathology ; HIV Infections - virology ; HIV-1 - physiology ; Humans ; Male ; Measurement ; Medicin och hälsovetenskap ; Middle Aged ; Patient outcomes ; Prognosis ; Viral Load</subject><ispartof>AIDS research and human retroviruses, 2007-10, Vol.23 (10), p.1183-1188</ispartof><rights>COPYRIGHT 2007 Mary Ann Liebert, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-393b5667b4c13cdce4913e664334876dfda6445acdec9d60dcfbebf544f056453</citedby><cites>FETCH-LOGICAL-c407t-393b5667b4c13cdce4913e664334876dfda6445acdec9d60dcfbebf544f056453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,3043,27928,27929</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17961102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:116190467$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Kowalska, Justyna D</creatorcontrib><creatorcontrib>Mocroft, Amanda</creatorcontrib><creatorcontrib>Blaxhult, Anders</creatorcontrib><creatorcontrib>Colebunders, Robert</creatorcontrib><creatorcontrib>van Lunzen, Jan</creatorcontrib><creatorcontrib>Podlekareva, Daria</creatorcontrib><creatorcontrib>Hansen, Ann-Brit Eg</creatorcontrib><creatorcontrib>Machala, Ladislav</creatorcontrib><creatorcontrib>Yust, Israel</creatorcontrib><creatorcontrib>Benfield, Thomas</creatorcontrib><creatorcontrib>EuroSIDA Study Group</creatorcontrib><creatorcontrib>for the EuroSIDA Study Group</creatorcontrib><title>Current hemoglobin levels are more predictive of disease progression than hemoglobin measured at baseline in patients receiving antiretroviral treatment for HIV type 1 infection</title><title>AIDS research and human retroviruses</title><addtitle>AIDS Res Hum Retroviruses</addtitle><description>The role of hemoglobin levels as an independent prognostic marker of progression to AIDS and/or death in HIV-infected patients starting combination antiretroviral therapy (cART) was investigated. A total of 2,579 patients from the EuroSIDA cohort with hemoglobin, CD4 cell count, and HIV RNA viral load measured 6 months prior to starting cART was included in the analyses. Anemia was defined as mild (<or=14 g/dl males, <or=12 g/dl females) and severe (<8 g/dl both genders). Poisson regression was used to determine factors related to clinical progression (new AIDS/death). Hemoglobin levels increased by a median of +0.48 g/dl (IQR -0.4 to +1.3) in the first year of cART. During 14,272 person years of follow-up (PYFU) there were 505 new AIDS/deaths. Of the patients 304 (11.8%) developed mild and 19 severe anemia (0.7%). In multivariate analysis baseline hemoglobin was significantly associated with progression to AIDS/death after starting cART with an IRR of 1.07 per 1 g/dl lower (95% CI 1.01-1.13; p = 0.023). When hemoglobin was fitted as a time-updated variable the IRR increased to 1.36 per 1 g/dl lower (95% CI 1.30-1.42; p < 0.001). Starting cART was associated with an increase in hemoglobin levels. Lower hemoglobin values, particularly the latest measured, were associated with an increased risk of disease progression.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Anemia</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiviral agents</subject><subject>CD4 Lymphocyte Count</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Disease Progression</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hemoglobin</subject><subject>Hemoglobins - analysis</subject><subject>HIV infection</subject><subject>HIV Infections - blood</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Measurement</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Viral Load</subject><issn>0889-2229</issn><issn>1931-8405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ksGP1CAUxonRuLOrR6-GxMRbRyiUluNmorubbOJFvRIKr7MoLRXobPbP8j-UZkbHixcgL7_vvS-PD6E3lGwp6eQH7ey2JkRsSS3rZ2hDJaNVx0nzHG1I18mqrmt5gS5T-k4IkXXdvEQXtJWCUlJv0K_dEiNMGT_AGPY-9G7CHg7gE9YR8BjKMUewzmR3ABwGbF0CndZq2EdIyYUJ5wc9_dthLMRSVFhn3BfYuwlwqc86uzIs4QgG3MFNe6yn7CLkGA4uao9zBJ3H1dAQIr69-4bz0wyYFvUAxUOYXqEXg_YJXp_uK_T108cvu9vq_vPN3e76vjKctLlikvWNEG3PDWXGGuCSMhCCM8a7VtjBasF5o40FI60g1gw99EPD-UAawRt2hapj3_QI89KrObpRxycVtFOn0o_yAtWItpG88PK_fNmVPYv-CCkVVBIu2qJ9f9QW8OcCKavRJQPe6wnCkpToOOMtEwV8dwT32oMqOwk5arPC6ppKKnhbfvVs3cSQUoThrxlK1JoaVVKj1tSoNTWFf3sav_Qj2DN9ign7De_VwzA</recordid><startdate>20071001</startdate><enddate>20071001</enddate><creator>Kowalska, Justyna D</creator><creator>Mocroft, Amanda</creator><creator>Blaxhult, Anders</creator><creator>Colebunders, Robert</creator><creator>van Lunzen, Jan</creator><creator>Podlekareva, Daria</creator><creator>Hansen, Ann-Brit Eg</creator><creator>Machala, Ladislav</creator><creator>Yust, Israel</creator><creator>Benfield, Thomas</creator><general>Mary Ann Liebert, Inc</general><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>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>20071001</creationdate><title>Current hemoglobin levels are more predictive of disease progression than hemoglobin measured at baseline in patients receiving antiretroviral treatment for HIV type 1 infection</title><author>Kowalska, Justyna D ; 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A total of 2,579 patients from the EuroSIDA cohort with hemoglobin, CD4 cell count, and HIV RNA viral load measured 6 months prior to starting cART was included in the analyses. Anemia was defined as mild (<or=14 g/dl males, <or=12 g/dl females) and severe (<8 g/dl both genders). Poisson regression was used to determine factors related to clinical progression (new AIDS/death). Hemoglobin levels increased by a median of +0.48 g/dl (IQR -0.4 to +1.3) in the first year of cART. During 14,272 person years of follow-up (PYFU) there were 505 new AIDS/deaths. Of the patients 304 (11.8%) developed mild and 19 severe anemia (0.7%). In multivariate analysis baseline hemoglobin was significantly associated with progression to AIDS/death after starting cART with an IRR of 1.07 per 1 g/dl lower (95% CI 1.01-1.13; p = 0.023). When hemoglobin was fitted as a time-updated variable the IRR increased to 1.36 per 1 g/dl lower (95% CI 1.30-1.42; p < 0.001). Starting cART was associated with an increase in hemoglobin levels. Lower hemoglobin values, particularly the latest measured, were associated with an increased risk of disease progression.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>17961102</pmid><doi>10.1089/aid.2006.0292</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0889-2229 |
| ispartof | AIDS research and human retroviruses, 2007-10, Vol.23 (10), p.1183-1188 |
| issn | 0889-2229 1931-8405 |
| language | eng |
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| source | Mary Ann Liebert Online Subscription; MEDLINE; Alma/SFX Local Collection |
| subjects | Adult AIDS/HIV Anemia Anti-HIV Agents - therapeutic use Antiviral agents CD4 Lymphocyte Count Cohort Studies Complications and side effects Development and progression Disease Progression Dosage and administration Drug therapy Female Health aspects Hemoglobin Hemoglobins - analysis HIV infection HIV Infections - blood HIV Infections - drug therapy HIV Infections - physiopathology HIV Infections - virology HIV-1 - physiology Humans Male Measurement Medicin och hälsovetenskap Middle Aged Patient outcomes Prognosis Viral Load |
| title | Current hemoglobin levels are more predictive of disease progression than hemoglobin measured at baseline in patients receiving antiretroviral treatment for HIV type 1 infection |
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