Abstract
Background: Immunological non-response (INR) despite virological suppression is associated with AIDS-defining events/death (ADE). Little is known about its association with serious non-AIDS-defining events (nADE). Methods Patients highly-active antiretroviral therapy (HAART) with 50. Results: 1221 patients were observed for a median of 3 (IQR: 1.3-6.1) years. Pre-HAART CD4+were 77/μl (IQR: 28-142) and 56% of patients had experienced an ADE. After 1 year, CD4+ increased to 286 (IQR: 197-387), but 26.1% of patients were INR. Thereafter, 86 nADE (30.2% malignancies, 27.9%infectious, 17.4%renal, 17.4%cardiovascular, 7% hepatic) were observed, accounting for an incidence of 1.83 events (95%CI: 1.73-2.61) per 100 PYFU. After adjusting for measurable confounders, INR had a significantly greater risk of nADE (HR 1.65; 95%CI: 1.06-2.56). Older age (per year, HR 1.03; 95%CI: 1.01-1.05), hepatitis C co-infection (HR 2.09; 95%CI: 1.19-3.7), a history of previous nADE (HR 2.16; 95% CI: 1.06-4.4) and the occurrence of ADE during the follow-up (HR 2.2; 95%CI: 1.15-4.21) were other independent predictors of newly diagnosed nADE. Conclusions: Patients failing to restore CD4+ to >200 cells/μl run a greater risk of serious nADE, which is intertwined or predicted by AIDS progression. Improved management of this fragile population and innovative therapy able to induce immune-reconstitution are urgently needed. Also, our results strengthen the importance of earlier diagnosis and HAART introduction.
| Original language | English |
|---|---|
| Article number | e0124741 |
| Journal | PLoS One |
| Volume | 10 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 28 2015 |
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ASJC Scopus subject areas
- Agricultural and Biological Sciences(all)
- Biochemistry, Genetics and Molecular Biology(all)
- Medicine(all)
Cite this
Risk of severe non AIDS events is increased among patients unable to increase their CD4 + T-cell counts >200+/μl despite effective HAART. / Lapadula, Giuseppe; Chatenoud, Liliane; Gori, Andrea; Castelli, Francesco; Di Giambenedetto, Simona; Fabbiani, Massimiliano; Maggiolo, Franco; Focà, Emanuele; Ladisa, Nicoletta; Sighinolfi, Laura; Di Pietro, Massimo; Pan, Angelo; Torti, Carlo; Carosi, G.; Quiros, E.; Nasta, P.; Paraninfo, G.; Cauda, R.; Colafigli, M.; Scalzini, A.; Castelnuovo, F.; El Hamad, I.; Mazzotta, F.; Locaputo, S.; Pierotti, P.; Marino, N.; Blè, C.; Vichi, F.; Angarano, G.; Ladisa, N.; Monno, L.; Maggi, P.; Costarelli, S.; Puoti, M.; Viale, P.; Colangeli, V.; Borderi, M.
In: PLoS One, Vol. 10, No. 5, e0124741, 28.05.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk of severe non AIDS events is increased among patients unable to increase their CD4 + T-cell counts >200+/μl despite effective HAART
AU - Lapadula, Giuseppe
AU - Chatenoud, Liliane
AU - Gori, Andrea
AU - Castelli, Francesco
AU - Di Giambenedetto, Simona
AU - Fabbiani, Massimiliano
AU - Maggiolo, Franco
AU - Focà, Emanuele
AU - Ladisa, Nicoletta
AU - Sighinolfi, Laura
AU - Di Pietro, Massimo
AU - Pan, Angelo
AU - Torti, Carlo
AU - Carosi, G.
AU - Quiros, E.
AU - Nasta, P.
AU - Paraninfo, G.
AU - Cauda, R.
AU - Colafigli, M.
AU - Scalzini, A.
AU - Castelnuovo, F.
AU - El Hamad, I.
AU - Mazzotta, F.
AU - Locaputo, S.
AU - Pierotti, P.
AU - Marino, N.
AU - Blè, C.
AU - Vichi, F.
AU - Angarano, G.
AU - Ladisa, N.
AU - Monno, L.
AU - Maggi, P.
AU - Costarelli, S.
AU - Puoti, M.
AU - Viale, P.
AU - Colangeli, V.
AU - Borderi, M.
PY - 2015/5/28
Y1 - 2015/5/28
N2 - Background: Immunological non-response (INR) despite virological suppression is associated with AIDS-defining events/death (ADE). Little is known about its association with serious non-AIDS-defining events (nADE). Methods Patients highly-active antiretroviral therapy (HAART) with 50. Results: 1221 patients were observed for a median of 3 (IQR: 1.3-6.1) years. Pre-HAART CD4+were 77/μl (IQR: 28-142) and 56% of patients had experienced an ADE. After 1 year, CD4+ increased to 286 (IQR: 197-387), but 26.1% of patients were INR. Thereafter, 86 nADE (30.2% malignancies, 27.9%infectious, 17.4%renal, 17.4%cardiovascular, 7% hepatic) were observed, accounting for an incidence of 1.83 events (95%CI: 1.73-2.61) per 100 PYFU. After adjusting for measurable confounders, INR had a significantly greater risk of nADE (HR 1.65; 95%CI: 1.06-2.56). Older age (per year, HR 1.03; 95%CI: 1.01-1.05), hepatitis C co-infection (HR 2.09; 95%CI: 1.19-3.7), a history of previous nADE (HR 2.16; 95% CI: 1.06-4.4) and the occurrence of ADE during the follow-up (HR 2.2; 95%CI: 1.15-4.21) were other independent predictors of newly diagnosed nADE. Conclusions: Patients failing to restore CD4+ to >200 cells/μl run a greater risk of serious nADE, which is intertwined or predicted by AIDS progression. Improved management of this fragile population and innovative therapy able to induce immune-reconstitution are urgently needed. Also, our results strengthen the importance of earlier diagnosis and HAART introduction.
AB - Background: Immunological non-response (INR) despite virological suppression is associated with AIDS-defining events/death (ADE). Little is known about its association with serious non-AIDS-defining events (nADE). Methods Patients highly-active antiretroviral therapy (HAART) with 50. Results: 1221 patients were observed for a median of 3 (IQR: 1.3-6.1) years. Pre-HAART CD4+were 77/μl (IQR: 28-142) and 56% of patients had experienced an ADE. After 1 year, CD4+ increased to 286 (IQR: 197-387), but 26.1% of patients were INR. Thereafter, 86 nADE (30.2% malignancies, 27.9%infectious, 17.4%renal, 17.4%cardiovascular, 7% hepatic) were observed, accounting for an incidence of 1.83 events (95%CI: 1.73-2.61) per 100 PYFU. After adjusting for measurable confounders, INR had a significantly greater risk of nADE (HR 1.65; 95%CI: 1.06-2.56). Older age (per year, HR 1.03; 95%CI: 1.01-1.05), hepatitis C co-infection (HR 2.09; 95%CI: 1.19-3.7), a history of previous nADE (HR 2.16; 95% CI: 1.06-4.4) and the occurrence of ADE during the follow-up (HR 2.2; 95%CI: 1.15-4.21) were other independent predictors of newly diagnosed nADE. Conclusions: Patients failing to restore CD4+ to >200 cells/μl run a greater risk of serious nADE, which is intertwined or predicted by AIDS progression. Improved management of this fragile population and innovative therapy able to induce immune-reconstitution are urgently needed. Also, our results strengthen the importance of earlier diagnosis and HAART introduction.
UR - http://www.scopus.com/inward/record.url?scp=84932627615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84932627615&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0124741
DO - 10.1371/journal.pone.0124741
M3 - Article
AN - SCOPUS:84932627615
VL - 10
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 5
M1 - e0124741
ER -