Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival
| Autor: | Mari M, Kitahata, Stephen J, Gange, Alison G, Abraham, Barry, Merriman, Michael S, Saag, Amy C, Justice, Robert S, Hogg, Steven G, Deeks, Joseph J, Eron, John T, Brooks, Sean B, Rourke, M John, Gill, Ronald J, Bosch, Jeffrey N, Martin, Marina B, Klein, Lisa P, Jacobson, Benigno, Rodriguez, Timothy R, Sterling, Gregory D, Kirk, Sonia, Napravnik, Anita R, Rachlis, Liviana M, Calzavara, Michael A, Horberg, Michael J, Silverberg, Kelly A, Gebo, James J, Goedert, Constance A, Benson, Ann C, Collier, Stephen E, Van Rompaey, Heidi M, Crane, Rosemary G, McKaig, Bryan, Lau, Aimee M, Freeman, Richard D, Moore, C, Lent |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Risk HPTN 052 medicine.medical_specialty HIV Infections Asymptomatic Article Drug Administration Schedule Acquired immunodeficiency syndrome (AIDS) Bias Internal medicine medicine Humans Survival analysis Proportional Hazards Models business.industry Proportional hazards model HIV Confounding Factors Epidemiologic General Medicine Middle Aged medicine.disease Survival Analysis Confidence interval Surgery CD4 Lymphocyte Count Anti-Retroviral Agents Relative risk Cohort Disease Progression RNA Viral Female medicine.symptom business |
| DOI: | 10.17615/adzc-0430 |
| Popis: | BACKGROUND The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain. METHODS We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy. In each group, we stratified the patients according to the CD4+ count (351 to 500 cells per cubic millimeter or >500 cells per cubic millimeter) at the initiation of antiretroviral therapy. In each group, we compared the relative risk of death for patients who initiated therapy when the CD4+ count was above each of the two thresholds of interest (early-therapy group) with that of patients who deferred therapy until the CD4+ count fell below these thresholds (deferred-therapy group). RESULTS In the first analysis, which involved 8362 patients, 2084 (25%) initiated therapy at a CD4+ count of 351 to 500 cells per cubic millimeter, and 6278 (75%) deferred therapy. After adjustment for calendar year, cohort of patients, and demographic and clinical characteristics, among patients in the deferred-therapy group there was an increase in the risk of death of 69%, as compared with that in the early-therapy group (relative risk in the deferred-therapy group, 1.69; 95% confidence interval [CI], 1.26 to 2.26; P |
| Databáze: | OpenAIRE |
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