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Impact of baseline viral load and adherence on survival of HIV-infected adults with baseline CD4 cell counts > or = 200 cells/microl.
AIDS 2006; 20(8):1117-23AIDS

Abstract

BACKGROUND

Baseline plasma HIV RNA levels > 100 000 copies/ml have been associated with elevated mortality rates after the initiation of HAART. There is uncertainty regarding the optimal strategy for patients with high plasma HIV RNA but CD4 cell count > or = 200 cells/microl.

OBJECTIVE

To evaluate the impact of baseline plasma HIV RNA on survival among patients with CD4 cell counts > or = 200 cells/microl.

METHODS

Patients were stratified by plasma HIV RNA, CD4 cell count and adherence level. Mortality rates were evaluated using Kaplan-Meier methods and Cox regression.

RESULTS

Among 1166 patients initiating HAART with a CD4 cell count > or = 200 cells/microl, a baseline HIV RNA > or = 100 000 copies/ml was statistically associated with elevated mortality among non-adherent patients (log-rank P = 0.032), but not for adherent patients (log-rank P = 0.690). In a multivariate Cox model comparing patients with a baseline CD4 cell count > or = 200 cells/microl and a baseline plasma HIV RNA < 100 000 copies/ml, the mortality rate was statistically similar among patients with a baseline CD4 cell count > or = 200 cells/microl and a baseline plasma HIV RNA > or = 100 000 copies/ml (relative hazard, 1.21; 95% confidence interval, 0.89-1.65; P = 0.232).

CONCLUSION

HIV RNA > or = 100 000 copies/ml was only associated with mortality among HIV-infected patients initiating HAART with CD4 cell counts > or= 200 cells/microl if the patients were non-adherent.

Authors+Show Affiliations

British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, 667-1081 Burrard Street, Vancouver, BC, Canada.No 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

16691062

Citation

Wood, Evan, et al. "Impact of Baseline Viral Load and Adherence On Survival of HIV-infected Adults With Baseline CD4 Cell Counts > or = 200 Cells/microl." AIDS (London, England), vol. 20, no. 8, 2006, pp. 1117-23.
Wood E, Hogg RS, Yip B, et al. Impact of baseline viral load and adherence on survival of HIV-infected adults with baseline CD4 cell counts > or = 200 cells/microl. AIDS. 2006;20(8):1117-23.
Wood, E., Hogg, R. S., Yip, B., Moore, D., Harrigan, P. R., & Montaner, J. S. (2006). Impact of baseline viral load and adherence on survival of HIV-infected adults with baseline CD4 cell counts > or = 200 cells/microl. AIDS (London, England), 20(8), pp. 1117-23.
Wood E, et al. Impact of Baseline Viral Load and Adherence On Survival of HIV-infected Adults With Baseline CD4 Cell Counts > or = 200 Cells/microl. AIDS. 2006 May 12;20(8):1117-23. PubMed PMID: 16691062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of baseline viral load and adherence on survival of HIV-infected adults with baseline CD4 cell counts > or = 200 cells/microl. AU - Wood,Evan, AU - Hogg,Robert S, AU - Yip,Benita, AU - Moore,David, AU - Harrigan,P Richard, AU - Montaner,Julio S G, PY - 2006/5/13/pubmed PY - 2006/6/30/medline PY - 2006/5/13/entrez SP - 1117 EP - 23 JF - AIDS (London, England) JO - AIDS VL - 20 IS - 8 N2 - BACKGROUND: Baseline plasma HIV RNA levels > 100 000 copies/ml have been associated with elevated mortality rates after the initiation of HAART. There is uncertainty regarding the optimal strategy for patients with high plasma HIV RNA but CD4 cell count > or = 200 cells/microl. OBJECTIVE: To evaluate the impact of baseline plasma HIV RNA on survival among patients with CD4 cell counts > or = 200 cells/microl. METHODS: Patients were stratified by plasma HIV RNA, CD4 cell count and adherence level. Mortality rates were evaluated using Kaplan-Meier methods and Cox regression. RESULTS: Among 1166 patients initiating HAART with a CD4 cell count > or = 200 cells/microl, a baseline HIV RNA > or = 100 000 copies/ml was statistically associated with elevated mortality among non-adherent patients (log-rank P = 0.032), but not for adherent patients (log-rank P = 0.690). In a multivariate Cox model comparing patients with a baseline CD4 cell count > or = 200 cells/microl and a baseline plasma HIV RNA < 100 000 copies/ml, the mortality rate was statistically similar among patients with a baseline CD4 cell count > or = 200 cells/microl and a baseline plasma HIV RNA > or = 100 000 copies/ml (relative hazard, 1.21; 95% confidence interval, 0.89-1.65; P = 0.232). CONCLUSION: HIV RNA > or = 100 000 copies/ml was only associated with mortality among HIV-infected patients initiating HAART with CD4 cell counts > or= 200 cells/microl if the patients were non-adherent. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/16691062/Impact_of_baseline_viral_load_and_adherence_on_survival_of_HIV_infected_adults_with_baseline_CD4_cell_counts_>_or_=_200_cells/microl_ L2 - http://Insights.ovid.com/pubmed?pmid=16691062 DB - PRIME DP - Unbound Medicine ER -