Factors associated with clinical progression in HIV-2 infected-patients: the French ANRS cohort
| Autor: | Pauline Campa, Roger Salamon, Florence Damond, Sophie Pueyo, Sophie Matheron, Annie Leprêtre, François Simon, Geneviève Chêne, Françoise Brun-Vézinet |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Male medicine.medical_specialty Immunology HIV Infections Gastroenterology Group B Risk Factors Internal medicine Immunology and Allergy Medicine Humans Protease Inhibitors Prospective Studies Risk factor Prospective cohort study Proportional Hazards Models Acquired Immunodeficiency Syndrome Proportional hazards model business.industry Hazard ratio Age Factors Viral Load Prognosis Confidence interval CD4 Lymphocyte Count Infectious Diseases Anti-Retroviral Agents Cohort DNA Viral HIV-2 Disease Progression RNA Viral Female business Viral load |
| Zdroj: | AIDS (London, England). 17(18) |
| ISSN: | 0269-9370 |
| Popis: | Objectives: To identify factors associated with clinical progression in HIV-2 infected patients. Design: French prospective cohort initiated in 1994. Methods: Follow-up data are collected twice a year; viral load is assessed once a year by cellular viraemia, quantitative proviral DNA and plasma RNA. A Cox proportional-hazards model was used for studying baseline factors associated with clinical progression. Results: By December 2001, 217 patients had been enrolled. At inclusion, 80%, 6% and 14% were Centers for Disease Control and Prevention (CDC) group A, B and C, respectively. Median CD4 cell count was 436 × 10 6 /l. In the 48% of positive specimens, the median plasma RNA titre was 3.0 log 10 copies/ml. Mean follow-up of the 179 patients seen at least twice was 34.4 months. Of these 13 died and nine progressed to group C. Ninety-three (52%) received antiretroviral therapy during a mean of 33 months, including a protease inhibitor in 48%. The probability of remaining AIDS-free was 97% and 95% at 1 and 3 years, respectively. Independent variables associated with clinical progression were age ≥ 40 years [hazard ratio (HR), 11; 95% confidence interval (Cl), 1.4-91.8; P = 0.03] and plasma RNA (HR, 2.5 per additional log 10 copies/ml; 95% Cl, 1.3-4.7, P< 0.01). Prior group B symptoms and CD4 cell count < 200 x 10 6 /l were associated with progression to AIDS. AIDS and plasma RNA were predictive of death. Conclusion: Considering the limited progression rate of HIV-2 infection, combined antiretroviral therapy should be discussed in patients with high plasma RNA titres, which threshold value remains to be defined. It is recommended in case of AIDS, CDC group B symptoms or CD4 cell count < 200 × 10 6 /l. |
| Databáze: | OpenAIRE |
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