The clinical benefits of antiretroviral therapy in severely immunocompromised HIV-1-infected patients with and without complete viral suppression
| Autor: | Amanda Mocroft, Bannister, Wendy P., Ole Kirk, Kowalska, Justyna D., Peter Reiss, Arminio-Monforte, Antonella D., Jose Gatell, Martin Fisher, Hanna Trocha, Aza Rakhmanova, Lundgren, Jens D., The EuroSIDA Study in EuroCOORD, Matti Ristola |
|---|---|
| Přispěvatelé: | Mocroft, Amanda, Bannister, Wendy P., Kirk, Ole, Kowalska, Justyna D., Reiss, Peter, D'arminio monforte, Antonella, Gatell, Jose, Fisher, Martin, Trocha, Hanna, Rakhmanova, Aza, Lundgren, Jens D, Eurosida In, Eurocoord, Castagna, Antonella, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Global Health |
| Předmět: |
Male
medicine.medical_treatment Rate ratio 0302 clinical medicine Risk Factors Pharmacology (medical) 030212 general & internal medicine Poisson Distribution Prospective Studies Prospective cohort study Acquired Immunodeficiency Syndrome/ drug therapy/immunology Adult CD4 Lymphocyte Count Drug Evaluation Drug Therapy Combination/methods Female Follow-Up Studies HIV Protease Inhibitors/ therapeutic use HIV-1/immunology/pathogenicity Humans Immunocompromised Host Incidence Middle Aged Reverse Transcriptase Inhibitors/ therapeutic use Viral Load Viremia/virology 0303 health sciences Incidence (epidemiology) Immunosuppression Reverse Transcriptase Inhibitor 3. Good health Infectious Diseases symbols Reverse Transcriptase Inhibitors Drug Therapy Combination Viral load Human Cart medicine.medical_specialty Follow-Up Studie 03 medical and health sciences symbols.namesake Acquired immunodeficiency syndrome (AIDS) Internal medicine medicine Poisson regression Viremia HIV Protease Inhibitor Pharmacology Acquired Immunodeficiency Syndrome 030306 microbiology business.industry Risk Factor HIV Protease Inhibitors medicine.disease Prospective Studie Immunology HIV-1 business |
| Zdroj: | University of Helsinki Antiviral therapy, 17(7), 1291-1300. International Medical Press Ltd Antiviral Therapy; Vol 17 |
| ISSN: | 1359-6535 |
| Popis: | Background The aim of this study was to determine whether there is a protective effect of combination anti-retroviral therapy (cART) on the development of clinical events in patients with ongoing severe immunosuppression. Methods A total of 3,780 patients from the EuroSIDA study under follow-up after 2001 with a current CD4+ T-cell count ≤200 cells/mm3 were stratified into five groups: group 1, viral load (VL)Results There were 428 AIDS/non-AIDS events during 3,780 person-years of follow-up. Compared with group 1, those in group 2 had a similar incidence of AIDS/ non-AIDS events (incidence rate ratio [IRR] 1.04; 95% CI 0.79–1.36). Groups 3, 4 and 5 had significantly higher incidence rates of AIDS/non-AIDS events compared with group 1; incidence rates increased from group 3 (IRR 1.78; 95% CI 1.25–2.55) to group 5 (IRR 2.36; 95% CI 1.66–3.40), demonstrating the increased incidence of AIDS/non-AIDS events associated with increasing viraemia. After adjustment, the use of cART was associated with a 40% reduction in the incidence of AIDS/non-AIDS events in patients with VL 50–99,999 copies/ml (IRR 0.59; 95% CI 0.41–0.85) and in those with a VL>100,000 copies/ml (IRR 0.66; 95% CI 0.44–1.00). Similar relationships were seen for non-AIDS events and AIDS events when considered separately. Conclusions In patients with ongoing severe immuno-suppression, cART was associated with significant clinical benefits in patients with suboptimal virological control or virological failure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|