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Virological control during the first 6-18 months after initiating highly active antiretroviral therapy as a predictor for outcome in HIV-infected patients: a Danish, population-based, 6-year follow-up study.
Clin Infect Dis 2006; 42(1):136-44CI

Abstract

BACKGROUND

Our objective was to examine whether virological control during the first 6-18 months after HAART initiation is a predictor for viral suppression, CD4+ cell count increase, and mortality in human immunodeficiency virus (HIV)-infected patients 18-90 months after initiation of highly active antiretroviral therapy (HAART).

METHODS

We conducted a population-based observational cohort study in Denmark. Patients were divided into 3 groups, according to the proportion of time each patient had a detectable HIV RNA load (i.e., > or = 400 copies/mL) during the 6-18 months after HAART initiation: 0% of the time interval (group 1), 1%-99% of the time interval (group 2), and 100% of the time interval (group 3). The proportion of patients with undetectable HIV RNA, CD4+ cell count changes, and mortality were examined by logistic, linear, and Cox regression analyses, respectively. We constructed cumulative mortality curves.

RESULTS

We observed 2046 patients, for a total of 8898 person-years of follow-up that started at 18 months after HAART initiation. Mean CD4+ cell count increase rates during 72 months of follow-up were as follows: group 1, 3.3 x 10(6) cells/L per month (95% confidence interval [CI], 2.9-3.7 x 10(6) cells/L); group 2, 2.9 x 10(6) (95% CI, 2.5-3.3 x 10(6) cells/L); and group 3, 2.6 x 10(6) (95% CI, 2.0-3.3 x 10(6) cells/L). Survival at 72 months were as follows: group 1, 92.7% (95% CI, 90.5%-94.4%); group 2, 85.6% (95% CI, 82.1%-88.5%); and group 3, 76.1% (95% CI, 70.6%-80.7%). At 72 months, 96% of group 1, 83% of group 2, and 57% of group 3 had an HIV RNA load of < 400 copies/mL (P < .01). Treatment interruption before baseline was a predictor of mortality in group 2 (adjusted rate ratio, 2.94; 95% CI, 1.75-4.92]).

CONCLUSIONS

Viral suppression during the first 6-18 months after HAART initiation predicts viral suppression, CD4+ cell count progression, and survival at 72 months.

Authors+Show Affiliations

Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. nicolai.lohse@ouh.fyns-amt.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16323104

Citation

Lohse, Nicolai, et al. "Virological Control During the First 6-18 Months After Initiating Highly Active Antiretroviral Therapy as a Predictor for Outcome in HIV-infected Patients: a Danish, Population-based, 6-year Follow-up Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 42, no. 1, 2006, pp. 136-44.
Lohse N, Kronborg G, Gerstoft J, et al. Virological control during the first 6-18 months after initiating highly active antiretroviral therapy as a predictor for outcome in HIV-infected patients: a Danish, population-based, 6-year follow-up study. Clin Infect Dis. 2006;42(1):136-44.
Lohse, N., Kronborg, G., Gerstoft, J., Larsen, C. S., Pedersen, G., Pedersen, C., ... Obel, N. (2006). Virological control during the first 6-18 months after initiating highly active antiretroviral therapy as a predictor for outcome in HIV-infected patients: a Danish, population-based, 6-year follow-up study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 42(1), pp. 136-44.
Lohse N, et al. Virological Control During the First 6-18 Months After Initiating Highly Active Antiretroviral Therapy as a Predictor for Outcome in HIV-infected Patients: a Danish, Population-based, 6-year Follow-up Study. Clin Infect Dis. 2006 Jan 1;42(1):136-44. PubMed PMID: 16323104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Virological control during the first 6-18 months after initiating highly active antiretroviral therapy as a predictor for outcome in HIV-infected patients: a Danish, population-based, 6-year follow-up study. AU - Lohse,Nicolai, AU - Kronborg,Gitte, AU - Gerstoft,Jan, AU - Larsen,Carsten Schade, AU - Pedersen,Gitte, AU - Pedersen,Court, AU - Sørensen,Henrik Toft, AU - Obel,Niels, Y1 - 2005/11/30/ PY - 2005/06/08/received PY - 2005/08/29/accepted PY - 2005/12/3/pubmed PY - 2006/7/26/medline PY - 2005/12/3/entrez SP - 136 EP - 44 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 42 IS - 1 N2 - BACKGROUND: Our objective was to examine whether virological control during the first 6-18 months after HAART initiation is a predictor for viral suppression, CD4+ cell count increase, and mortality in human immunodeficiency virus (HIV)-infected patients 18-90 months after initiation of highly active antiretroviral therapy (HAART). METHODS: We conducted a population-based observational cohort study in Denmark. Patients were divided into 3 groups, according to the proportion of time each patient had a detectable HIV RNA load (i.e., > or = 400 copies/mL) during the 6-18 months after HAART initiation: 0% of the time interval (group 1), 1%-99% of the time interval (group 2), and 100% of the time interval (group 3). The proportion of patients with undetectable HIV RNA, CD4+ cell count changes, and mortality were examined by logistic, linear, and Cox regression analyses, respectively. We constructed cumulative mortality curves. RESULTS: We observed 2046 patients, for a total of 8898 person-years of follow-up that started at 18 months after HAART initiation. Mean CD4+ cell count increase rates during 72 months of follow-up were as follows: group 1, 3.3 x 10(6) cells/L per month (95% confidence interval [CI], 2.9-3.7 x 10(6) cells/L); group 2, 2.9 x 10(6) (95% CI, 2.5-3.3 x 10(6) cells/L); and group 3, 2.6 x 10(6) (95% CI, 2.0-3.3 x 10(6) cells/L). Survival at 72 months were as follows: group 1, 92.7% (95% CI, 90.5%-94.4%); group 2, 85.6% (95% CI, 82.1%-88.5%); and group 3, 76.1% (95% CI, 70.6%-80.7%). At 72 months, 96% of group 1, 83% of group 2, and 57% of group 3 had an HIV RNA load of < 400 copies/mL (P < .01). Treatment interruption before baseline was a predictor of mortality in group 2 (adjusted rate ratio, 2.94; 95% CI, 1.75-4.92]). CONCLUSIONS: Viral suppression during the first 6-18 months after HAART initiation predicts viral suppression, CD4+ cell count progression, and survival at 72 months. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16323104/Virological_control_during_the_first_6_18_months_after_initiating_highly_active_antiretroviral_therapy_as_a_predictor_for_outcome_in_HIV_infected_patients:_a_Danish_population_based_6_year_follow_up_study_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/498515 DB - PRIME DP - Unbound Medicine ER -