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Long-term survival of HIV-infected patients treated with highly active antiretroviral therapy in Serbia and Montenegro.
HIV Med 2007; 8(2):75-9HM

Abstract

BACKGROUND

Highly active antiretroviral therapy (HAART) has dramatically changed the prognosis of HIV disease, even in terminally ill patients. Although these patients may survive many years after the diagnosis of AIDS if treated with HAART, some still die during treatment.

METHODS

A retrospective study in a cohort of 481 HIV-infected patients treated with HAART between January 1998 and December 2005 was conducted to compare subgroups of long-term survivors (LTSs) and patients who died during treatment.

RESULTS

A total of 48 patients survived for more than 72 months (mean 83.8+/-standard deviation 5.6 months). Thirty patients died during treatment (mean 35.3+/-25.0 months), of whom nine died from non-AIDS-related causes, 18 died from AIDS-related causes, and three died as a result of HAART toxicity. Although LTSs were significantly (P=0.015) younger at HAART initiation, age below 40 years was not a predictor of long-term survival. The subgroups did not differ in the proportion of clinical AIDS cases at HAART initiation, in the prevalence of hepatitic C virus (HCV) coinfection, or in pretreatment and end-of-follow-up CD4 cell counts. In contrast, the viral load achieved during treatment was lower in the survivors (P=0.03), as was the prevalence of hepatitis B virus (HBV) coinfection (P=0.03). Usage of either protease inhibitor (PI)-containing regimens [odds ratio (OR) 9.0, 95% confidence interval (CI) 2.2-35.98, P<0.001] or all three drug classes simultaneously (OR 7.4, 95% CI 2.2-25.1, P<0.001) was associated with long-term survival. Drug holidays incorporated in structured treatment interruption (STI) were also associated with a good prognosis (OR 14.9, 95% CI 2.9-75.6, P<0.001).

CONCLUSIONS

Long-term survival was associated with PI-based HAART regimens and lower viraemia, but not with the immunological status either at baseline or at the end of follow up. STI when CD4 counts reach 350 cells/microL, along with undetectable viraemia, was a strong predictor of long-term survival.

Authors+Show Affiliations

Institute of Infectious & Tropical Diseases, Belgrade University School of Medicine, Belgrade, Serbia.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

17352762

Citation

Jevtović, D O., et al. "Long-term Survival of HIV-infected Patients Treated With Highly Active Antiretroviral Therapy in Serbia and Montenegro." HIV Medicine, vol. 8, no. 2, 2007, pp. 75-9.
Jevtović DO, Salemović D, Ranin J, et al. Long-term survival of HIV-infected patients treated with highly active antiretroviral therapy in Serbia and Montenegro. HIV Med. 2007;8(2):75-9.
Jevtović, D. O., Salemović, D., Ranin, J., Pesić, I., Zerjav, S., & Djurković-Djaković, O. (2007). Long-term survival of HIV-infected patients treated with highly active antiretroviral therapy in Serbia and Montenegro. HIV Medicine, 8(2), pp. 75-9.
Jevtović DO, et al. Long-term Survival of HIV-infected Patients Treated With Highly Active Antiretroviral Therapy in Serbia and Montenegro. HIV Med. 2007;8(2):75-9. PubMed PMID: 17352762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term survival of HIV-infected patients treated with highly active antiretroviral therapy in Serbia and Montenegro. AU - Jevtović,D O, AU - Salemović,D, AU - Ranin,J, AU - Pesić,I, AU - Zerjav,S, AU - Djurković-Djaković,O, PY - 2007/3/14/pubmed PY - 2007/11/9/medline PY - 2007/3/14/entrez SP - 75 EP - 9 JF - HIV medicine JO - HIV Med. VL - 8 IS - 2 N2 - BACKGROUND: Highly active antiretroviral therapy (HAART) has dramatically changed the prognosis of HIV disease, even in terminally ill patients. Although these patients may survive many years after the diagnosis of AIDS if treated with HAART, some still die during treatment. METHODS: A retrospective study in a cohort of 481 HIV-infected patients treated with HAART between January 1998 and December 2005 was conducted to compare subgroups of long-term survivors (LTSs) and patients who died during treatment. RESULTS: A total of 48 patients survived for more than 72 months (mean 83.8+/-standard deviation 5.6 months). Thirty patients died during treatment (mean 35.3+/-25.0 months), of whom nine died from non-AIDS-related causes, 18 died from AIDS-related causes, and three died as a result of HAART toxicity. Although LTSs were significantly (P=0.015) younger at HAART initiation, age below 40 years was not a predictor of long-term survival. The subgroups did not differ in the proportion of clinical AIDS cases at HAART initiation, in the prevalence of hepatitic C virus (HCV) coinfection, or in pretreatment and end-of-follow-up CD4 cell counts. In contrast, the viral load achieved during treatment was lower in the survivors (P=0.03), as was the prevalence of hepatitis B virus (HBV) coinfection (P=0.03). Usage of either protease inhibitor (PI)-containing regimens [odds ratio (OR) 9.0, 95% confidence interval (CI) 2.2-35.98, P<0.001] or all three drug classes simultaneously (OR 7.4, 95% CI 2.2-25.1, P<0.001) was associated with long-term survival. Drug holidays incorporated in structured treatment interruption (STI) were also associated with a good prognosis (OR 14.9, 95% CI 2.9-75.6, P<0.001). CONCLUSIONS: Long-term survival was associated with PI-based HAART regimens and lower viraemia, but not with the immunological status either at baseline or at the end of follow up. STI when CD4 counts reach 350 cells/microL, along with undetectable viraemia, was a strong predictor of long-term survival. SN - 1464-2662 UR - https://www.unboundmedicine.com/medline/citation/17352762/Long_term_survival_of_HIV_infected_patients_treated_with_highly_active_antiretroviral_therapy_in_Serbia_and_Montenegro_ L2 - https://doi.org/10.1111/j.1468-1293.2007.00429.x DB - PRIME DP - Unbound Medicine ER -