Academic Journal
Clinical progression of severely immunosuppressed HIV-infected patients depends on virological and immunological improvement irrespective of baseline status
| العنوان: | Clinical progression of severely immunosuppressed HIV-infected patients depends on virological and immunological improvement irrespective of baseline status |
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| المؤلفون: | Ferrer, Elena, Curto, Jordi, Esteve, Anna, Miro, Jose M., Tural, Cristina, Murillas, Javier, Segura, Ferran, Barrufet, Pilar, Casabona, Jordi, Podzamczer, Daniel, on behalf of the PISCIS Investigators, Casabona, J., Miró, Jose M., Campbell, C. N. J., Esteve, A., Miró, J. M., Podzamczer, D., Murillas, J., Gatell, J. M., Manzardo, C., Tural, C., Clotet, B., Ferrer, E., Riera, M., Segura, F., Navarro, G., Force, L., Vilaró, J., Masabeu, A., García, I., Mercadal, J., Cifuentes, C., Homar, F., Dalmau, D., Jaen, À., Domingo, P., Falcó, V., Curran, A., Agustí, C., Montoliu, A., Pérez, I., Curto, J., Gargoulas, F., Gómez, A., Rubia, J. C., Zamora, L., Blanco, J. L., Garcia-Alcaide, F., Martínez, E., Mallolas, J., Llibre, J. M., Sirera, G., Romeu, J., Jou, A., Negredo, E., Saumoy, M., Imaz, A., Bolao, F., Cabellos, C., Peña, C., DiYacovo, S., Van Den Eynde, E., Sala, M., Cervantes, M., Amengual, M. J., Navarro, M., Segura, V., Barrufet, P., Molina, J., Alvaro, M., Orriols, M., Payeras, T., Gracia Mateo, Mª., Fernández, J. |
| بيانات النشر: | Oxford University Press |
| سنة النشر: | 2015 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Original research |
| الوصف: | <$O_ST_ABS>Objectives<$C_ST_ABS>The aim of this study was to analyse factors associated with progression to AIDS/death in severely immunosuppressed HIV-infected patients receiving ART. <$O_ST_ABS>Methods<$C_ST_ABS>This study included naive patients from the PISCIS Cohort with CD4 <200 cells/mm3 at enrolment and who initiated ART consisting of two nucleoside analogues plus either a PI or an NNRTI between 1998 and 2011. The PISCIS Cohort is a multicentre, observational study of HIV-infected individuals aged >18 years followed at 14 participating hospitals in Catalonia and the Balearic Islands (Spain). Clinical and laboratory parameters were assessed every 3–4 months during follow-up. Cox regression models were used to assess the effect of CD4 and viral load on the risk of progression to AIDS/death, adjusting for baseline variables and confounders. <$O_ST_ABS>Results<$C_ST_ABS>2295 patients were included and, after 5 years, 69.9% reached CD4 200 cells/mm3, 64.4% had an undetectable viral load and 482 (21%) progressed to AIDS/death. The lowest rate of disease progression was found in patients who reached both immunological and viral responses during follow-up, regardless of their baseline situation (1.9% in baseline CD4 >100 cells/mm3 and viral load <5 log copies/mL; 2.3% in baseline CD4 100 cells/mm3 and/or viral load >5 log copies/mL). Achieving a CD4 count 200 cells/mm3 was the main predictor of decreased progression to AIDS/death. In those not reaching this CD4 threshold, virological response reduced disease progression by half. <$O_ST_ABS>Conclusions<$C_ST_ABS>Even in the worse baseline scenario of CD4 100 cells/mm3 and high baseline viral loads, positive virological and immunological responses were associated with dramatic decreases in progression. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| Relation: | http://jac.oxfordjournals.org/cgi/content/short/70/12/3332; http://dx.doi.org/10.1093/jac/dkv272 |
| DOI: | 10.1093/jac/dkv272 |
| الاتاحة: | http://jac.oxfordjournals.org/cgi/content/short/70/12/3332 https://doi.org/10.1093/jac/dkv272 |
| Rights: | Copyright (C) 2015, The British Society for Antimicrobial Chemotherapy |
| رقم الانضمام: | edsbas.AAA246FD |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/jac/dkv272 |
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