Relationship between CD4+ T-cell counts/HIV-1 RNA plasma viral load and AIDS-defining events among persons followed in the ACTG longitudinal linked randomized trials study.
| Autor: | Smurzynski M; Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA. msmurzyn@sdac.harvard.edu, Wu K, Benson CA, Bosch RJ, Collier AC, Koletar SL |
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| Jazyk: | angličtina |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2010 Sep; Vol. 55 (1), pp. 117-27. |
| DOI: | 10.1097/QAI.0b013e3181e8c129 |
| Abstrakt: | Background: AIDS-defining events (ADEs) decreased in the era of highly active antiretroviral therapy but still lead to hospitalizations and deaths. Understanding factors related to ADEs is important to mitigate events. Methods: We examined the relationship between demographics, behaviors, comorbidities, laboratory, clinical measurements, and ADEs diagnosed among subjects randomized to antiretroviral treatments (ART)/strategies and followed prospectively. Logistic regression models using generalized estimating equations generated odds ratios (ORs) focusing on the relationship between current CD4 T-cell count (CD4)/HIV-1 RNA viral load (VL) and ADEs in the subsequent 16-week study period. Results: Among the 2948 subjects in the analysis, overall incidence of ADEs was 1.53 per 100 person-years. Multivariate regression models adjusted for demographics, body mass index, and ADE history. A 6-level time-varying variable examined VL (>100,000 copies/mL, < or =100,000) at CD4 levels (0-50, 51-200, >200 cells/microL); reference level was CD4 >200/VL < or =100,000. Among ART naives, odds of having an ADE in the subsequent 16-week interval were greater among subjects with lower CD4 counts; this relationship was modified by VL level (CD4 < or =50/VL >100,000: OR 37.2; CD4 < or =50/VL < or =100,000: OR 30.5; CD4 51-200/VL >100,000: OR 13.0; CD4 51-200/VL < or =100,000: OR 4.5; all P values <0.001). Similar results were seen among ART-experienced subjects. Conclusions: Recent CD4 and VL values are closely associated with development of ADEs even after examining a multitude of potential factors. |
| Databáze: | MEDLINE |
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