Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy : not all AIDS-defining conditions are created equal

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RESEARCH PRODUCT

Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy : not all AIDS-defining conditions are created equal

Antiretroviral Therapy Cohort Collaboration Mocroft A Sterne Ja Egger M May M Grabar S Furrer H Sabin C Fatkenheuer G Justice A Reiss P D'arminio Monforte A Gill J Hogg R Bonnet F Kitahata M Staszewski S Casabona J Harris R Saag M Casabona J Chêne G Costagliola D Dabis F D'arminio Monforte A De Wolf F Egger M Fatkenheuer G Gill J Hogg R Justice A Kitahata M Ledergerber B Mocroft A Phillips A Reiss P Saag M Sabin C Staszewski S Weller I May M Harris R Sterne J Abgrall S Barin F Bentata M Billaud E Boué F Burty C Cabié A Cotte L De Truchis P Duval X Duvivier C Enel P Fredouille Heripret L Gasnault J Gaud C Gilquin J Grabar S Katlama C Khuong Ma Lang Jm Lascaux As Launay O Mahamat A Mary Krause M Matheron S Meynard Jl Pavie J Pialoux G Pilorgé F Poizot Martin I Pradier C Reynes J Rouveix E Simon A Tattevin P Tissot Dupont H Viard Jp Viget N Pariente Khayat A Salomon V Jacquemet N Rivet A Guiguet M Kousignian I Lanoy E Lièvre L Potard V Selinger Leneman H Bouvet E Crickx B Ecobichon Jl Leport C Picard Dahan C Yeni P Tisne Dessus D Weiss L Salmon D Sicard D Auperin I Roudière L Fior R Delfraissy Jf Goujard C Jung C Lesprit P Desplanque N Meyohas Mc Picard O Cadranel J Mayaud C Bricaire F Herson S Clauvel Jp Decazes Jm Gerard L Molina Jm Diemer M Sellier P Berthé H Dupont C Chandemerle C Mortier E Honoré P Jeantils V Tassi S Mechali D Taverne B Gourdon F Laurichesse H Fresard A Lucht F Eglinger P Faller Jp Bazin C Verdon R Boibieux A Peyramond D Livrozet Jm Touraine Jl Trepo C Ravaux I Delmont Jp Moreau J Gastaut Ja Retornaz F Soubeyrand J Allegre T Blanc Pa Galinier A Ruiz Jm Lepeu G Granet Brunello P Esterni Jp Pelissier L Cohen Valensi R Nezri M Chadapaud S Laffeuillade A May T Rabaud C Raffi F Arvieux C Michelet C Borsa Lebas F Caron F Fraisse P Rey D Arlet Suau E Cuzin L Massip P Thiercelin Legrand Mf Yasdanpanah Y Pradinaud R Sobesky M Contant M Montroni M Scalise G Braschi Mc Riva A Tirelli U Martellotta F Pastore G Ladisa N Suter F Arici C Chiodo F Colangeli V Fiorini C Carosi G Cristini G Torti C Minardi C Bertelli D Quirino T Manconi Pe Piano P Cosco L Scerbo A Vecchiet J D'alessandro M Santoro D Pusterla L Carnevale G Lorenzotti S Viganò P Mena M Ghinelli F Sighinolfi L Leoncini F Mazzotta F Pozzi M Lo Caputo S Grisorio B Ferrara S Grima P Grima Pf Pagano G Cassola G Alessandrini A Piscopo R Toti M Trezzi M Soscia F Tacconi L Orani A Perini P Scasso A Vincenti A Chiodera F Castelli P Scalzini A Palvarini L Moroni M Lazzarin A Rizzardini G Caggese L Cicconi P Galli A Merli S Pastecchia C Moioli Mc Esposito R Mussini C Abrescia N Chirianni A Izzo Cm Piazza M De Marco M Viglietti R Manzillo E Colomba A Abbadessa V Prestileo T Mancuso S Ferrari C Pizzaferri P Filice G Minoli L Bruno R Novati S Baldelli F Camanni G Petrelli E Cioppi A Alberici F Ruggieri A Menichetti F Martinelli C De Stefano C La Gala A Ballardini G Rizzo E Magnani G Ursitti Ma Arlotti M Ortolani P Cauda R Dianzani F Ippolito G Antinori A Antonucci G Ciardi M Narciso P Petrosillo N Vullo V De Luca A Zaccarelli M Acinapura R De Longis P Trotta Mp Noto P Lichtner M Capobianchi Mr Carletti F Girardi E Pezzotti P Rezza G Mura Ms Mannazzu M Caramello P Di Perri G Orofino Gc Sciandra M Grossi Pa Basilico C Poggio A Bottari G Raise E Ebo F Pellizzer G Buonfrate D Resta F Loso K Cozzi Lepri A Battegay M Bernasconi E Böni J Bucher H Bürgisser P Cattacin S Cavassini M Dubs R Elzi L Erb P Fischer M Flepp M Fontana A Francioli P Furrer H Gorgievski M Günthard H Hirsch H Hirschel B Hösli I Kahlert C Kaiser L Karrer U Kind C Klimkait T Martinetti G Martinez B Müller N Nadal D Opravil M Paccaud F Pantaleo G Rickenbach M Rudin C Schmid P Schultze D Schüpbach J Speck R Taffé P Tarr P Telenti A Trkola A Vernazza P Weber R Yerly S Gras La Van Sighem Ai Smit C Bronsveld W Hillebrand Haverkort Me Prins Jm Branger J Eeftinck Schattenkerk Jk Gisolf J Godfried Mh Lange Jm Lettinga Kd Van Der Meer Jt Nellen Fj Van Der Poll T Ruys Ta Steingrover R Vermeulen Jn Vrouenraets Sm Van Vugt M Wit Fw Kuijpers Tw Pajkrt D Scherpbier Hj Van Eeden A Brinkman K Van Den Berk Ge Blok Wl Frissen Ph Roos Jc Schouten We Mulder Jw Van Gorp Ec Wagenaar J Veenstra J Danner Sa Van Agtmael Ma Claessen Fa Perenboom Rm Rijkeboer A Van Vonderen Mg Richter C Van Der Berg J Vriesendorp R Jeurissen Fj Kauffmann Rh Pogány K Bravenboer B Ten Napel Ch Kootstra Gj Sprenger Hg Van Assen S Van Leeuwen Jt Doedens R Scholvinck Eh Ten Kate Rw Soetekouw R Van Houte D Polée Mb Kroon Fp Van Den Broek Pj Van Dissel Jt Schippers Ef Schreij G Van Der Geest S Lowe S Verbon A Koopmans Pp Van Crevel R De Groot R Keuter M Post F Van Der Ven Aj Warris A Van Der Ende Me Gyssens Ic Van Der Feltz M Nouwen Jl Rijnders Bj De Vries Te Driessen G Van Der Flier M Hartwig Ng Juttman Jr Van Kasteren Me Van De Heul C Hoepelman Im Schneider Mm Bonten Mj Borleffs Jc Ellerbroek Pm Jaspers Ca Mudrikove T Schurink Ca Gisolf Eh Geelen Sp Wolfs Tf Faber T Tanis Aa Groeneveld Ph Den Hollander Jg Duits Aj Winkel K Back Nk Bakker Me Berkhout B Jurriaans S Zaaijer Hl Cuijpers T Rietra Pj Roozendaal Kj Pauw W Van Zanten Ap Smits Ph Von Blomberg Bm Savelkoul P Pettersson A Swanink Cm Franck Pf Lampe As Jansen Cl Hendriks R Benne Ca Veenendaal D Storm H Weel J Van Zeijl Jh Kroes Ac Claas Hc Bruggeman Ca Goossens Vj Galama Jm Melchers Wj Poort Ya Doornum Gj Niesters Mg Osterhaus Ad Schutten M Buiting Ag Swaans Ca Boucher Ca Schuurman R Boel E Jansz Af Veldkamp A Beijnen Jh Huitema Ad Burger Dm Hugen Pw Van Kan Hj Losso M Duran A Vetter N Karpov I Vassilenko A Mitsura Vm Suetnov O Clumeck N De Wit S Poll B Colebunders R Kostov K Begovac J Machala L Rozsypal H Sedlacek D Nielsen J Lundgren J Benfield T Kirk O Gerstoft J Katzenstein T Hansen Ab Skinhøj P Pedersen C Oestergaard L Zilmer K Ristola M Girard Pm Vanhems P Rockstroh J Schmidt R Van Lunzen J Degen O Stellbrink Hj Bogner J Kosmidis J Gargalianos P Xylomenos G Perdios J Panos G Filandras A Karabatsaki E Sambattakou H Banhegyi D Mulcahy F Yust I Turner D Burke M Pollack S Hassoun G Maayan S Chiesi A Mazeu I Pristera R Gabbuti A Montesarchio E Gargiulo M Iacomi F Vlassi C Finazzi R Galli M Ridolfo A Rozentale B Aldins P Chaplinskas S Hemmer R Staub T Bruun J Maeland A Ormaasen V Knysz B Gasiorowski J Horban A Prokopowicz D Wiercinska Drapalo A Boron Kaczmarska A Pynka M Beniowski M Mularska E Trocha H Antunes F Valadas E Mansinho K Maltez F Duiculescu D Rakhmanova A Vinogradova E Buzunova S Jevtovic D Mokrás M Staneková D González Lahoz J Soriano V Martin Carbonero L Labarga P Clotet B Jou A Conejero J Tural C Gatell Jm Miró Jm Domingo P Gutierrez M Mateo G Sambeat Ma Karlsson A Persson Po Flamholc L Boffi E Kravchenko E Chentsova N Barton S Johnson Am Mercey D Johnson Ma Murphy M Weber J Scullard G Fisher M Brettle R Gatell J Gazzard B Friis Møller N Bannister W Ellefson M Borch A Podlekareva D Holkmann Olsen C Kjaer J Peters L Reekie J Raffanti S Dieterch D Becker S Scarsella A Fusco G Most B Balu R Rana R Beckerman R Ising T Fusco J Irek R Johnson B Hirani A Dejesus E Pierone G Lackey P Irek C Johnson A Burdick J Leon S Arch J Helm Eb Carlebach A Müller A Haberl A Nisius G Lennemann T Stephan C Bickel M Mösch M Gute P Locher L Lutz T Klauke S Knecht G Khaykin P Doerr Hw Stürmer M Babacan E Von Hentig N Beylot J Dupon M Longy Boursier M Pellegrin Jl Ragnaud Jm Salamon R Thiébaut R Lewden C Lawson Ayayi S Dupon M Mercié P Moreau Jf Morlat P Bernard N Lacoste D Malvy D Neau D Blaizeau Mj Decoin M Delveaux S Hannapier C Labarrère S Lavignolle Aurillac V Uwamaliya Nziyumvira B Palmer G Touchard D Balestre E Alioum A Jacqmin Gadda H Bonarek M Bonnet F Coadou B Gellie P Nouts C Bocquentin F Dutronc H Lafarie S Aslan A Pistonne T Thibaut P Vatan R Chambon D De La Taille C Cazorla C Ocho A Viallard Jf Caubet O Cipriano C Lazaro E Couzigou P Castera L Fleury H Lafon Me Masquelier B Pellegrin I Breilh D Blanco P Loste P Caunègre L Bonnal F Farbos S Ferrand M Ceccaldi J Tchamgoué S De Witte S Buy E Alexander C Barrios R Braitstein P Brumme Z Chan K Cote H Gataric N Geller J Guillemi S Harrigan Pr Harris M Joy R Levy A Montaner J Montessori V Palepu A Phillips E Phillips P Press N Tyndall M Wood E Yip B Bhagani S Breen R Byrne P Carroll A Cuthbertson Z Dunleavy A Geretti Am Heelan B Johnson M Kinloch De Loes S Lipman M Madge S Marshall N Nair D Nebbia G Prinz B Shah S Swader L Tyrer M Youle M Chaloner C Grabowska H Holloway J Puradiredja J Ransom D Tsintas R Bansi L Fox Z Harris E Hill T Lampe F Lodwick R Smith C Amoah E Booth C Clewley G Garcia Diaz A Gregory B Janossy G Labbett W Thomas M Read R Krentz H Beckthold B Schmeisser N Alquézar A Esteve A Podzamczer D Murillas J Romero A Agustí C Agüero F Ferrer E Riera M Segura F Navarro G Force L Vilaró J Masabeu A García I Guadarrama M Montoliu A Ortega N Lazzari E Puchol E Sanchez M Blanco Jl Garcia Alcaide F Martinez E Mallolas J López Dieguez M García Goez Jf Sirera G Romeu J Negredo E Miranda C Capitan Mc Olmo M Barragan P Saumoy M Bolao F Cabellos C Peña C Sala M Cervantes M Jose Amengual M Navarro M Penelo E Barrufet P Raper Jl Mugavero Mj Willig Jh Schumacher J Chang Pw Westfall Ao Cloud G Lin Hy Acosta Ep Colette Kempf M Allison Jj Pisu M.Salvatore Nappa

subject

Male Infectious diseases and international health [NCEBP 13]Lymphoma 030312 virology Esophageal candidiasis Cohort Studies 0302 clinical medicine Interquartile range 030212 general & internal medicine AIDS-Related Lymphoma AIDS-Related 0303 health sciences Mortality rate Progressive multifocal leukoencephalopathy Hazard ratio Prognosis 3. Good health Pathogenesis and modulation of inflammation [N4i 1]Infectious Diseases Combination Drug Therapy Combination Female Infection and autoimmunity [NCMLS 1]Human Microbiology (medical)Adult medicine.medical_specialty Prognosi Anti-HIV Agents antiretroviral therapy Infectious Disease Article AIDS-Related Opportunistic Infection 03 medical and health sciences Acquired immunodeficiency syndrome (AIDS)Drug Therapy Internal medicine medicine Humans AIDS-defining event Proportional Hazards Models AIDS-Related Opportunistic Infections/diagnosis/ mortality; Acquired Immunodeficiency Syndrome/complications/diagnosis/drug; therapy/ mortality; Adult; Anti-HIV Agents/ therapeutic use; Cohort Studies; Drug Therapy; Combination; Female; Humans; Lymphoma; AIDS-Related/diagnosis/mortality; Male; Prognosis; Proportional Hazards Models Acquired Immunodeficiency Syndrome AIDS-Related Opportunistic Infections business.industry Proportional hazards model Poverty-related infectious diseases [N4i 3]Anti-HIV Agent medicine.disease mortality Confidence interval Immunology Proportional Hazards Model Cohort Studie business

description

Contains fulltext : 80963.pdf (Publisher’s version ) (Open Access) BACKGROUND: The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. METHODS: We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a "rare ADEs" category. RESULTS: During a median follow-up period of 43 months (interquartile range, 19-70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin's lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84-22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70-14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin's lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55-9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76-3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08-2.00]). CONCLUSIONS: In the combination antiretroviral therapy era, mortality rates subsequent to an ADE depend on the specific diagnosis. The proposed classification of ADEs may be useful in clinical end point trials, prognostic studies, and patient management.

year	journal	country	edition	language
2009-04-15

10.1086/597468 https://doi.org/10.1086/597468