Current and Past Immunodeficiency Are Associated With Higher Hospitalization Rates Among Persons on Virologically Suppressive Antiretroviral Therapy for up to 11 Years
| Autor: | Thibaut, Davy-Mendez, Sonia, Napravnik, Joseph J, Eron, Stephen R, Cole, David, van Duin, David A, Wohl, Brenna C, Hogan, Keri N, Althoff, Kelly A, Gebo, Richard D, Moore, Michael J, Silverberg, Michael A, Horberg, M John, Gill, W Christopher, Mathews, Marina B, Klein, Jonathan A, Colasanti, Timothy R, Sterling, Angel M, Mayor, Peter F, Rebeiro, Kate, Buchacz, Jun, Li, Ni Gusti Ayu, Nanditha, Jennifer E, Thorne, Ank, Nijhawan, Stephen A, Berry, Sally, Coburn |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Canada Anti-HIV Agents 030106 microbiology Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Cohort Studies 03 medical and health sciences Major Articles and Brief Reports 0302 clinical medicine Internal medicine medicine Immunology and Allergy Humans 030212 general & internal medicine Immunodeficiency business.industry Viral Load medicine.disease Immunologic Deficiency Syndromes Antiretroviral therapy 3. Good health CD4 Lymphocyte Count VIROLOGIC FAILURE Hospitalization Infectious Diseases Female business Cohort study |
| Zdroj: | J Infect Dis |
| ISSN: | 1537-6613 |
| Popis: | Background Persons with human immunodeficiency virus (PWH) with persistently low CD4 counts despite efficacious antiretroviral therapy could have higher hospitalization risk. Methods In 6 US and Canadian clinical cohorts, PWH with virologic suppression for ≥1 year in 2005–2015 were followed until virologic failure, loss to follow-up, death, or study end. Stratified by early (years 2–5) and long-term (years 6–11) suppression and lowest presuppression CD4 count Results The 6997 included patients (19 980 person-years) were 81% cisgender men and 40% white. Among patients with lowest presuppression CD4 count 500 cells/μL had aIRRs of 1.44 during early suppression (95% confidence interval [CI], 1.01–2.06), and 1.67 (95% CI, 1.03–2.72) during long-term suppression. Among patients with lowest presuppression CD4 count ≥200 (56%), patients with current CD4 351–500 vs >500 cells/μL had an aIRR of 1.22 (95% CI, .93–1.60) during early suppression and 2.09 (95% CI, 1.18–3.70) during long-term suppression. Conclusions Virologically suppressed patients with lower CD4 counts experienced higher hospitalization rates and could potentially benefit from targeted clinical management strategies. |
| Databáze: | OpenAIRE |
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