Abstract
Objective: Many patients infected with HIV still present with an AIDS diagnosis. The aim of this study was to evaluate the virological, immunological and clinical outcomes of HAART in these patients. Design: The present study was a multi-cohort study. All patients with an AIDS diagnosis between 30 days before and 14 days after HIV diagnosis, recruited between 1997 and 2004 from eight hospital cohorts, were evaluated. Results: A total of 760 patients were included [268 (35.3%) had Pneumocystis and 168 (22.1%) tuberculosis]. Six hundred and twenty-four patients (82.1%) started HAART a median of 31 days after HIV diagnosis. One hundred and fifty-three patients started a nonnucleoside transcriptase inhibitor-based regimen (20.1%), 409 a protease inhibitorbased regimen (53.8%) and 62 other regimens (8.2%). In adjusted analyses, HAART was started sooner in more recent years, in patients with lower CD4 cell count and in those with Kaposi's sarcoma, whereas it was started later in those with tuberculosis. Five hundred and five patients (89%) attained a viral load of less than 500 copies/ml. The factors associated with a better virological response were later calendar year, lower initial viral load and cytomegalovirus disease. Virological rebound was more common in those receiving nucleoside reverse transcriptase inhibitor-based regimens, in those with tuberculosis and in earlier calendar years. One hundred and twenty-five (16%) patients died; 61 had received HAART (48.6%). Mortality was more likely in those who were older, those with a higher viral load at diagnosis, those with nonsexual HIV risks and those with lower CD4 cell count and haemoglobin levels over follow-up. Conclusion: Virological suppression was achieved in most AIDS patients, though mortality remains high in these individuals.
| Original language | English |
|---|---|
| Pages (from-to) | 2461-2469 |
| Number of pages | 9 |
| Journal | AIDS (London, England) |
| Volume | 22 |
| Issue number | 18 |
| DOIs | |
| Publication status | Published - 2008 |
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Keywords
- AIDS
- AIDS presenters
- Opportunistic infections
- Prognosis
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases
Cite this
Patients presenting with AIDS in the HAART era : A collaborative cohort analysis. / Mussini, Cristina; Manzardo, Christian; Johnson, Margaret; Monforte, Antonella D Arminio; Uberti-Foppa, Caterina; Antinori, Andrea; Gill, M. John; Sighinolfi, Laura; Borghi, Vanni; Lazzarin, Adriano; Miro, José M.; Sabin, Caroline.
In: AIDS (London, England), Vol. 22, No. 18, 2008, p. 2461-2469.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patients presenting with AIDS in the HAART era
T2 - A collaborative cohort analysis
AU - Mussini, Cristina
AU - Manzardo, Christian
AU - Johnson, Margaret
AU - Monforte, Antonella D Arminio
AU - Uberti-Foppa, Caterina
AU - Antinori, Andrea
AU - Gill, M. John
AU - Sighinolfi, Laura
AU - Borghi, Vanni
AU - Lazzarin, Adriano
AU - Miro, José M.
AU - Sabin, Caroline
PY - 2008
Y1 - 2008
N2 - Objective: Many patients infected with HIV still present with an AIDS diagnosis. The aim of this study was to evaluate the virological, immunological and clinical outcomes of HAART in these patients. Design: The present study was a multi-cohort study. All patients with an AIDS diagnosis between 30 days before and 14 days after HIV diagnosis, recruited between 1997 and 2004 from eight hospital cohorts, were evaluated. Results: A total of 760 patients were included [268 (35.3%) had Pneumocystis and 168 (22.1%) tuberculosis]. Six hundred and twenty-four patients (82.1%) started HAART a median of 31 days after HIV diagnosis. One hundred and fifty-three patients started a nonnucleoside transcriptase inhibitor-based regimen (20.1%), 409 a protease inhibitorbased regimen (53.8%) and 62 other regimens (8.2%). In adjusted analyses, HAART was started sooner in more recent years, in patients with lower CD4 cell count and in those with Kaposi's sarcoma, whereas it was started later in those with tuberculosis. Five hundred and five patients (89%) attained a viral load of less than 500 copies/ml. The factors associated with a better virological response were later calendar year, lower initial viral load and cytomegalovirus disease. Virological rebound was more common in those receiving nucleoside reverse transcriptase inhibitor-based regimens, in those with tuberculosis and in earlier calendar years. One hundred and twenty-five (16%) patients died; 61 had received HAART (48.6%). Mortality was more likely in those who were older, those with a higher viral load at diagnosis, those with nonsexual HIV risks and those with lower CD4 cell count and haemoglobin levels over follow-up. Conclusion: Virological suppression was achieved in most AIDS patients, though mortality remains high in these individuals.
AB - Objective: Many patients infected with HIV still present with an AIDS diagnosis. The aim of this study was to evaluate the virological, immunological and clinical outcomes of HAART in these patients. Design: The present study was a multi-cohort study. All patients with an AIDS diagnosis between 30 days before and 14 days after HIV diagnosis, recruited between 1997 and 2004 from eight hospital cohorts, were evaluated. Results: A total of 760 patients were included [268 (35.3%) had Pneumocystis and 168 (22.1%) tuberculosis]. Six hundred and twenty-four patients (82.1%) started HAART a median of 31 days after HIV diagnosis. One hundred and fifty-three patients started a nonnucleoside transcriptase inhibitor-based regimen (20.1%), 409 a protease inhibitorbased regimen (53.8%) and 62 other regimens (8.2%). In adjusted analyses, HAART was started sooner in more recent years, in patients with lower CD4 cell count and in those with Kaposi's sarcoma, whereas it was started later in those with tuberculosis. Five hundred and five patients (89%) attained a viral load of less than 500 copies/ml. The factors associated with a better virological response were later calendar year, lower initial viral load and cytomegalovirus disease. Virological rebound was more common in those receiving nucleoside reverse transcriptase inhibitor-based regimens, in those with tuberculosis and in earlier calendar years. One hundred and twenty-five (16%) patients died; 61 had received HAART (48.6%). Mortality was more likely in those who were older, those with a higher viral load at diagnosis, those with nonsexual HIV risks and those with lower CD4 cell count and haemoglobin levels over follow-up. Conclusion: Virological suppression was achieved in most AIDS patients, though mortality remains high in these individuals.
KW - AIDS
KW - AIDS presenters
KW - Opportunistic infections
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=57349112308&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57349112308&partnerID=8YFLogxK
U2 - 10.1097/QAD.0b013e328314b5f1
DO - 10.1097/QAD.0b013e328314b5f1
M3 - Article
VL - 22
SP - 2461
EP - 2469
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 18
ER -