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Prognosis of patients treated with cART from 36 months after initiation, according to current and previous CD4 cell count and plasma HIV-1 RNA measurements

Lanoy, E; May, M; Mocroft, A; Phillips, A; Justice, A; Chene, G; Furrer, H; ... Antiretroviral Therapy Cohort, ; + view all (2009) Prognosis of patients treated with cART from 36 months after initiation, according to current and previous CD4 cell count and plasma HIV-1 RNA measurements. AIDS , 23 (16) 2199 - 2208. 10.1097/QAD.0b013e3283305a00.

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Abstract

Objectives: CD4 cell count and plasma viral load are well known predictors of AIDS and mortality in HIV-1-infected patients treated with combination antiretroviral therapy (cART). This study investigated, in patients treated for at least 3 years, the respective prognostic importance of values measured at cART initiation, and 6 and 36 months later, for AIDS and death.Methods: Patients from 15 HIV cohorts included in the ART Cohort Collaboration, aged at least 16 years, anti retroviral-naive when they started cART and followed for at least 36 months after start of cART were eligible.Results: Among 14208 patients, the median CD4 cell counts at 0, 6 and 36 months were 210, 320 and 450 cells/mu l, respectively, and 78% of patients achieved viral load less than 500 copies/ml at 6 months. In models adjusted for characteristics at cART initiation and for values at all time points, values at 36 months were the strongest predictors of subsequent rates of AIDS and death. Although CD4 cell count and viral load at cART initiation were no longer prognostic of AIDS or of death after 36 months, viral load at 6 months and change in CD4 cell count from 6 to 36 months were prognostic for rates of AIDS from 36 months.Conclusions: Although current values of CD4 cell count and HIV-1 RNA are the most important prognostic factors for subsequent AIDS and death rates in HIV-1-infected patients treated with cART, changes in CD4 cell count from 6 to 36 months and the value of 6-month HIV-1 RNA are also prognostic for AIDS. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Type: Article
Title: Prognosis of patients treated with cART from 36 months after initiation, according to current and previous CD4 cell count and plasma HIV-1 RNA measurements
DOI: 10.1097/QAD.0b013e3283305a00
Keywords: cART, CD4 cell count, mortality, plasma HIV-1 RNA, prognosis of AIDS, ACTIVE ANTIRETROVIRAL THERAPY, VIROLOGICAL TREATMENT FAILURE, HIV-1-INFECTED PATIENTS, CLINICAL PROGRESSION, PROTEASE INHIBITOR, COLLABORATIVE ANALYSIS, DISEASE PROGRESSION, INFECTED PATIENTS, FOLLOW-UP, COHORT
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/106753
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