Engsig, Frederik N., Zangerle, Robert, Katsarou, Olga, Dabis, Francois, Reiss, Peter, Gill, John, Porter, Kholoud ORCID: 0000-0002-9226-6206, Sabin, Caroline ORCID: 0000-0001-5173-2760, Riordan, Andrew, Faetkenheuer, Gerd, Gutierrez, Felix ORCID: 0000-0002-9485-6867, Raffi, Francois, Kirk, Ole, Mary-Krause, Murielle, Stephan, Christoph, Garcia de Olalla, Patricia, Guest, Jodie ORCID: 0000-0002-3650-3975, Samji, Hasina ORCID: 0000-0002-4555-7609, Castagna, Antonella ORCID: 0000-0002-8338-9714, Monforte, Antonella d'Arminio, Skaletz-Rorowski, Adriane, Ramos, Jose, Lapadula, Giuseppe, Mussini, Cristina, Force, Lluis, Meyer, Laurence, Lampe, Fiona ORCID: 0000-0001-6851-5471, Boufassa, Faroudy, Bucher, Heiner C., De Wit, Stephane, Burkholder, Greer A., Teira, Ramon, Justice, Amy C., Sterling, Tim R., Crane, Heidi M., Gerstoft, Jan, Grarup, Jesper, May, Margaret, Chene, Genevieve, Ingle, Suzanne M., Sterne, Jonathan ORCID: 0000-0001-8496-6053 and Obel, Niels (2014). Long-term Mortality in HIV-Positive Individuals Virally Suppressed for > 3 Years With Incomplete CD4 Recovery. Clin. Infect. Dis., 58 (9). S. 1312 - 1322. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

Full text not available from this repository.

Abstract

Background. Some human immunodeficiency virus (HIV)-infected individuals initiating combination antiretroviral therapy (cART) with low CD4 counts achieve viral suppression but not CD4 cell recovery. We aimed to identify (1) risk factors for failure to achieve CD4 count >200 cells/mu L after 3 years of sustained viral suppression and (2) the association of the achieved CD4 count with subsequent mortality. Methods. We included treated HIV-infected adults from 2 large international HIV cohorts, who had viral suppression (<= 500 HIV type 1 RNA copies/mL) for >3 years with CD4 count <= 200 cells/mu L at start of the suppressed period. Logistic regression was used to identify risk factors for incomplete CD4 recovery (<= 200 cells/mu L) and Cox regression to identify associations with mortality. Results. Of 5550 eligible individuals, 835 (15%) did not reach a CD4 count >200 cells/mu L after 3 years of suppression. Increasing age, lower initial CD4 count, male heterosexual and injection drug use transmission, cART initiation after 1998, and longer time from initiation of cART to start of the virally suppressed period were risk factors for not achieving a CD4 count >200 cells/mu L. Individuals with CD4 <= 200 cells/mu L after 3 years of viral suppression had substantially increased mortality (adjusted hazard ratio, 2.60; 95% confidence interval, 1.86-3.61) compared with those who achieved CD4 count >200 cells/mu L. The increased mortality was seen across different patient groups and for all causes of death. Conclusions. Virally suppressed HIV-positive individuals on cART who do not achieve a CD4 count >200 cells/mu L have substantially increased long-term mortality.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Engsig, Frederik N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zangerle, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katsarou, OlgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dabis, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reiss, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gill, JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Porter, KholoudUNSPECIFIEDorcid.org/0000-0002-9226-6206UNSPECIFIED
Sabin, CarolineUNSPECIFIEDorcid.org/0000-0001-5173-2760UNSPECIFIED
Riordan, AndrewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Faetkenheuer, GerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutierrez, FelixUNSPECIFIEDorcid.org/0000-0002-9485-6867UNSPECIFIED
Raffi, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kirk, OleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mary-Krause, MurielleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stephan, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garcia de Olalla, PatriciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guest, JodieUNSPECIFIEDorcid.org/0000-0002-3650-3975UNSPECIFIED
Samji, HasinaUNSPECIFIEDorcid.org/0000-0002-4555-7609UNSPECIFIED
Castagna, AntonellaUNSPECIFIEDorcid.org/0000-0002-8338-9714UNSPECIFIED
Monforte, Antonella d'ArminioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Skaletz-Rorowski, AdrianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ramos, JoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lapadula, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Force, LluisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LaurenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lampe, FionaUNSPECIFIEDorcid.org/0000-0001-6851-5471UNSPECIFIED
Boufassa, FaroudyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bucher, Heiner C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Wit, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burkholder, Greer A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teira, RamonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Justice, Amy C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sterling, Tim R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Crane, Heidi M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerstoft, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grarup, JesperUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
May, MargaretUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chene, GenevieveUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ingle, Suzanne M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sterne, JonathanUNSPECIFIEDorcid.org/0000-0001-8496-6053UNSPECIFIED
Obel, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-439938
DOI: 10.1093/cid/ciu038
Journal or Publication Title: Clin. Infect. Dis.
Volume: 58
Number: 9
Page Range: S. 1312 - 1322
Date: 2014
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1537-6591
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACTIVE ANTIRETROVIRAL THERAPY; CELL COUNT; COLLABORATIVE ANALYSIS; VIROLOGICAL RESPONSE; IMMUNODEFICIENCY; INFECTION; AIDS; INITIATION; INCREASES; PROGNOSISMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/43993

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item