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2011-10-17

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cc-by (c) Miro, J.M. et al., 2011
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/44223

Survival outcomes and effect of early vs. deferred cART among HIV-infected patients diagnosed at the time of an AIDS-defining event: a cohort analysis.

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http://dx.doi.org/10.1371/journal.pone.0026009

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Objectives: We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART). Methods: Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997-2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death) was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (< 30 days after AIDS event) or deferred (30-270 days after AIDS event) cART. Results: The median (interquartile range) CD4 count and viral load (VL) at diagnosis of the 584 patients were 42 (16, 119) cells/ mL and 5.2 (4.5, 5.7) log 10 copies/mL. Clinical progression was observed in 165 (28.3%) patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL) (vs. other AIDS events) were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6%) received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p=0.20). Conclusions: Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting.

Matèries

VIH (Virus), Sida, Antiretrovirals, Terapèutica, Persones seropositives

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HIV (Viruses), AIDS (Disease), Antiretroviral agents, Therapeutics, HIV-positive persons

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Articles publicats en revistes (Medicina)

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MIRÓ MEDA, José m. (josé maría), MANZARDO, Christian, MUSSINI, Cristina, JOHNSON, Margaret m., D'ARMINIO MONFORTE, Antonella, ANTINORI, Antonella, GILL, M. john, SIGHINOLFI, Laura, UBERTI-FOPPA, Caterina, BORGHI, Vanni, SABIN, Caroline, Late Presenters Investigators. Survival outcomes and effect of early vs. deferred cART among HIV-infected patients diagnosed at the time of an AIDS-defining event: a cohort analysis.. _PLoS One_. 2011. Vol. 6, núm. 10, pàgs. e26009. [consulta: 23 de gener de 2026]. ISSN: 1932-6203. [Disponible a: https://hdl.handle.net/2445/44223]

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