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[HIV-1 therapy in the Netherlands; virological and immunological response to antiretroviral therapy].
Ned Tijdschr Geneeskd. 2001 Aug 18; 145(33):1591-7.NT

Abstract

OBJECTIVE

To evaluate the effect of treatment of HIV-1 infection with combination therapy consisting of since 1996 in the Netherlands available protease and reverse transcriptase inhibitors.

DESIGN

Prospective cohort study.

METHODS

In an observational clinical cohort of HIV-1-infected individuals, the short-term successful treatment end point of antiviral therapy including at least one antiretroviral drug licensed in the Netherlands since July 1, 1996 (protease inhibitors and reverse transcriptase inhibitors), was HIV-1 RNA plasma levels < or = 500 copies/ml (virological success). Cox proportional hazard models were used to identify prognostic markers for therapy success. The study included 2,148 infected individuals with a median follow-up of 135 weeks of treatment; 1,049 had been pre-treated with antiretroviral drugs before starting their new regimen and 1,099 were treatment naive.

RESULTS

Plasma HIV-1 RNA levels < or = 500 copies/ml at 24 weeks of treatment were seen in 61% of all patients. The chance of therapy success for naive patients was twice that for pre-treated patients (relative risk: 1.8; p < or = 0.001). Following the first 24 weeks, the chance of virological success was higher in the naive group (78% versus 63%; p < or = 0.001), and the number of naive patients failing therapy after initial success was smaller compared to pre-treated patients (22% versus 45%; p < or = 0.001). In the naive group, the CD4+ T-cell number increased from 239 to 440 (x 10(6) cells/l) in case of success, and decreased from 150 to 320 in case of treatment failure. HIV-1 related morbidity declined from 0.26 to 0.05 and mortality dropped from 0.07 to 0.03 per person-year of follow-up. Regimens were changed at least once in 76% of patients. Toxicity and therapy failure were the main reasons for regimen changes in naive and pre-treated patients, respectively.

CONCLUSION

A combination of antiretroviral drugs, including at least one of the drugs licensed since 1996, led to a drop in HIV-1 plasma concentrations. Morbidity and mortality also decreased. The chance of a better immunological and virological response to the new drug regimens was greatest in therapy-naive patients.

Authors+Show Affiliations

Afd. Klinische Epidemiologie en Biostatistiek, Academisch Medisch Centrum, afd. Humane Retrovirologie en Nationaal AIDS Therapie Evaluatie Centrum (NATEC), Meibergdreef 15, 1105 AZ Amsterdam.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
English Abstract
Journal Article
Multicenter Study

Language

dut

PubMed ID

11534377

Citation

Jambroes, M, et al. "[HIV-1 Therapy in the Netherlands; Virological and Immunological Response to Antiretroviral Therapy]." Nederlands Tijdschrift Voor Geneeskunde, vol. 145, no. 33, 2001, pp. 1591-7.
Jambroes M, Weverling GJ, Reiss P, et al. [HIV-1 therapy in the Netherlands; virological and immunological response to antiretroviral therapy]. Ned Tijdschr Geneeskd. 2001;145(33):1591-7.
Jambroes, M., Weverling, G. J., Reiss, P., Danner, S. A., Jurriaans, S., ten Veen, J. H., van der Ende, M. E., Schutten, M., Schneider, M. M., Schuurman, R., Mulder, J. W., Kroes, A. C., Lange, J. M., & de Wolf, F. (2001). [HIV-1 therapy in the Netherlands; virological and immunological response to antiretroviral therapy]. Nederlands Tijdschrift Voor Geneeskunde, 145(33), 1591-7.
Jambroes M, et al. [HIV-1 Therapy in the Netherlands; Virological and Immunological Response to Antiretroviral Therapy]. Ned Tijdschr Geneeskd. 2001 Aug 18;145(33):1591-7. PubMed PMID: 11534377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [HIV-1 therapy in the Netherlands; virological and immunological response to antiretroviral therapy]. AU - Jambroes,M, AU - Weverling,G J, AU - Reiss,P, AU - Danner,S A, AU - Jurriaans,S, AU - ten Veen,J H, AU - van der Ende,M E, AU - Schutten,M, AU - Schneider,M M, AU - Schuurman,R, AU - Mulder,J W, AU - Kroes,A C, AU - Lange,J M, AU - de Wolf,F, AU - ,, PY - 2001/9/6/pubmed PY - 2001/10/12/medline PY - 2001/9/6/entrez SP - 1591 EP - 7 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 145 IS - 33 N2 - OBJECTIVE: To evaluate the effect of treatment of HIV-1 infection with combination therapy consisting of since 1996 in the Netherlands available protease and reverse transcriptase inhibitors. DESIGN: Prospective cohort study. METHODS: In an observational clinical cohort of HIV-1-infected individuals, the short-term successful treatment end point of antiviral therapy including at least one antiretroviral drug licensed in the Netherlands since July 1, 1996 (protease inhibitors and reverse transcriptase inhibitors), was HIV-1 RNA plasma levels < or = 500 copies/ml (virological success). Cox proportional hazard models were used to identify prognostic markers for therapy success. The study included 2,148 infected individuals with a median follow-up of 135 weeks of treatment; 1,049 had been pre-treated with antiretroviral drugs before starting their new regimen and 1,099 were treatment naive. RESULTS: Plasma HIV-1 RNA levels < or = 500 copies/ml at 24 weeks of treatment were seen in 61% of all patients. The chance of therapy success for naive patients was twice that for pre-treated patients (relative risk: 1.8; p < or = 0.001). Following the first 24 weeks, the chance of virological success was higher in the naive group (78% versus 63%; p < or = 0.001), and the number of naive patients failing therapy after initial success was smaller compared to pre-treated patients (22% versus 45%; p < or = 0.001). In the naive group, the CD4+ T-cell number increased from 239 to 440 (x 10(6) cells/l) in case of success, and decreased from 150 to 320 in case of treatment failure. HIV-1 related morbidity declined from 0.26 to 0.05 and mortality dropped from 0.07 to 0.03 per person-year of follow-up. Regimens were changed at least once in 76% of patients. Toxicity and therapy failure were the main reasons for regimen changes in naive and pre-treated patients, respectively. CONCLUSION: A combination of antiretroviral drugs, including at least one of the drugs licensed since 1996, led to a drop in HIV-1 plasma concentrations. Morbidity and mortality also decreased. The chance of a better immunological and virological response to the new drug regimens was greatest in therapy-naive patients. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/11534377/[HIV_1_therapy_in_the_Netherlands L2 - http://www.diseaseinfosearch.org/result/9735 DB - PRIME DP - Unbound Medicine ER -