Survival after neuroAIDS: association with antiretroviral CNS Penetration-Effectiveness score
| Autor: | E, Lanoy, M, Guiguet, M, Bentata, E, Rouveix, C, Dhiver, I, Poizot-Martin, D, Costagliola, J, Gasnault, M, Contant |
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| Přispěvatelé: | Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Département de Recherche CLinique, CISIH-Sud, Hôpital Sainte-Marguerite, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), FHDH-ANRS CO4, Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) |
| Rok vydání: | 2011 |
| Předmět: |
Central Nervous System
Male AIDS Dementia Complex Cns penetration Cohort Studies 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases MESH: Neurologic Examination MESH: Cohort Studies MESH: Aged Neurologic Examination 0303 health sciences MESH: Middle Aged Progressive multifocal leukoencephalopathy Leukoencephalopathy Progressive Multifocal Middle Aged 3. Good health Anti-Retroviral Agents MESH: Young Adult Data Interpretation Statistical Toxoplasmosis Cerebral symbols [SDV.IMM]Life Sciences [q-bio]/Immunology Female Cart Adult medicine.medical_specialty Encephalopathy MESH: Anti-Retroviral Agents Plasma viral load 03 medical and health sciences symbols.namesake Young Adult MESH: Meningitis Internal medicine MESH: AIDS Dementia Complex medicine MESH: Central Nervous System Humans Meningitis Poisson regression Aged MESH: Humans 030306 microbiology business.industry MESH: Leukoencephalopathy Progressive Multifocal MESH: Adult medicine.disease Antiretroviral therapy Confidence interval MESH: Male Surgery MESH: Toxoplasmosis Cerebral Neurology (clinical) business MESH: Data Interpretation Statistical MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Neurology Neurology, American Academy of Neurology, 2011, 76 (7), pp.644-51. ⟨10.1212/WNL.0b013e31820c3089⟩ Neurology, 2011, 76 (7), pp.644-51. ⟨10.1212/WNL.0b013e31820c3089⟩ |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/WNL.0b013e31820c3089⟩ |
| Popis: | International audience; OBJECTIVE: We examined if the CNS Penetration-Effectiveness (CPE) score of antiretroviral drugs was associated with survival after a diagnosis of HIV-related encephalopathy, progressive multifocal leukoencephalopathy (PML), cerebral toxoplasmosis, or cryptococcal meningitis. METHODS: Using data from the FHDH-ANRS CO4, we compared the survival of 9,932 HIV-infected patients diagnosed with a first neurologic AIDS-defining event in the pre-combination antiretroviral therapy (cART) (1992-1995), early cART (1996-1998), or late cART (1999-2004) periods. Follow-up was subdivided (CPE < 1.5 and CPE ≥ 1.5), and relative rates (RR) of death were estimated using multivariable Poisson regression models. RESULTS: In the pre-cART and early cART periods, regimens with CPE ≥ 1.5 were associated with lower mortality after HIV-related encephalopathy (RR 0.64; 95% confidence interval [CI] 0.47-0.86 and RR 0.45; 95% CI 0.35-0.58) and after PML (RR 0.79; 95% CI 0.55-1.12 and RR 0.45; 95% CI 0.31-0.65), compared to regimens with CPE < 1.5, while in the late cART period there was no association between the CPE score and the mortality. A higher CPE score was also associated with a lower mortality in all periods after cerebral toxoplasmosis (RR 0.68, 95% CI 0.56-0.84) or cryptococcal meningitis (RR 0.50, 95% CI 0.34-0.74). Whatever the neurologic event, these associations were not maintained after adjustment on updated plasma HIV-RNA (missing |
| Databáze: | OpenAIRE |
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