LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Mortality associated with discordant responses to antiretroviral therapy in resource-constrained settings.

Publication

Author(s):

Tuboi SH, Pacheco AG, Harrison LH, Stone RA, May M, Brinkhof MW, Dabis F, Egger M, Nash D, Bangsberg D, Braitstein P, Yiannoutsos CT, Wood R, Sprinz E, Schechter M; ARTLINC of IeDEA.

Pub Title:

Mortality associated with discordant responses to antiretroviral therapy in resource-constrained settings.

Pub Date:

Feb 28 2010

Journal Issue:

1

Page Number:
70-7

Journal:

Title: 
JAIDS- Journal of Acquired Immune Deficiency Syndromes
Link: 
http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2010&issue=01010&article=00011&type=abstract

PubMed: 20035163
Pub PDF: PDF icon 20035163.pdf

Abstract
OBJECTIVES
: We assessed mortality associated with immunologic and virologic patterns of response at 6 months of highly active antiretroviral therapy (HAART) in HIV-infected individuals from resource-limited countries in Africa and South America.

METHODS: Patients who initiated HAART between 1996 and 2007, aged 16 years or older, and had at least 1 measurement (HIV-1 RNA plasma viral load or CD4 cell count) at 6 months of therapy (3-9 month window) were included. Therapy response was categorized as complete, discordant (virologic only or immunologic only), and absent. Associations between 6-month response to therapy and all-cause mortality were assessed by Cox proportional hazards regression. Robust standard errors were calculated to account for intrasite correlation.

RESULTS: A total of 7160 patients, corresponding to 15,107 person-years, were analyzed. In multivariable analysis adjusted for age at HAART initiation, baseline clinical stage and CD4 cell count, year of HAART initiation, clinic, occurrence of an AIDS-defining condition within the first 6 months of treatment, and discordant and absent responses were associated with increased risk of death.

CONCLUSIONS: Similar to reports from high-income countries, discordant immunologic and virologic responses were associated with intermediate risk of death compared with complete and no response in this large cohort of HIV-1 patients from resource-limited countries. Our results support a recommendation for wider availability of plasma viral load testing to monitor antiretroviral therapy in these settings.

PMID: 20035163 [PubMed - indexed for MEDLINE]

PMCID: PMC2802453

 
The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Tuboi SH, Pacheco AG, Harrison LH, Stone RA, May M, Brinkhof MW, Dabis F, Egger M, Nash D, Bangsberg D, Braitstein P, Yiannoutsos CT, Wood R, Sprinz E, Schechter M; ARTLINC of IeDEA. Mortality associated with discordant responses to antiretroviral therapy in resource-constrained settings. J Acquir Immune Defic Syndr. 2010 Jan;53(1):70-7. doi: 10.1097/QAI.0b013e3181c22d19. PubMed PMID: 20035163; PubMed Central PMCID: PMC2802453.