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Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?

Mocroft, A; Laut, K; Reiss, P; Gatell, J; Ormaasen, V; Cavassini, M; Hadziosmanovic, V; ... EuroSIDA study*, .; + view all (2017) Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV? AIDS 10.1097/QAD.0000000000001684. (In press). Green open access

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Abstract

OBJECTIVE: The extent to which controlled and uncontrolled HIV interact with ageing, European region of care and calendar year of follow-up is largely unknown. METHODS: EuroSIDA particpants were followed after 1/1/2001 and grouped according to current HIV progression risk; high risk [CD4 ≤350/mm, viral load ≥10,000 copies/ml], low risk [CD4 ≥500/mm, viral load <50 copies/ml], and intermediate [other combinations]. Poisson regression investigated interactions between HIV progression risk, age, European region of care, and year of follow-up and incidence of AIDS or non-AIDS events. RESULTS: 16839 persons were included with 136688 PYFU. In persons aged ≤30, those at high risk had a 6-fold increased incidence of non-AIDS compared to those at low risk, compared to a 2-3 fold increase in older persons (p=0.0004, interaction). In Eastern Europe; those at highest risk of non-AIDS had a 12-fold increased incidence compared to a 2-4-fold difference in all other regions (p = 0.0029, interaction). Those at high risk of non-AIDS during 2001-2004 had a 2-fold increased incidence compared to those at low risk, increasing to a 5-fold increase ≥2013 (p < 0.0001, interaction). Differences between high, intermediate and low risk of AIDS were similar across age groups, year of follow-up and Europe (p = 0.57, p = 0.060, p = 0.090 respectively, interaction). CONCLUSIONS: Factors other than optimal control of HIV become increasingly important with ageing for predicting non-AIDS while differences across Europe reflect differences in patient management as well as underlying socioeconomic circumstances. The difference between those at high, intermediate and low risk of non-AIDS ≥2013 likely reflects better quality of care.

Type: Article
Title: Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000001684
Publisher version: http://doi.org/10.1097/QAD.0000000000001684
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: AIDS; incidence; non-AIDS; risk of HIV disease progression
UCL classification: UCL
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 Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10038287
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