Dataset Information

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

ABSTRACT:

Background

CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterized.

Methods

We estimated mortality rates (MRs) by time since start of ART (<0.5, 0.5-0.9, 1-2.9, 3-4.9, 5-9.9, and ?10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate crude and adjusted (for sex, age, transmission risk, period of starting ART [1996-1997, 1998-1999, 2000-2001], and AIDS and human immunodeficiency virus type 1 RNA at baseline) mortality rate ratios (MRRs) by CD4 count at start of ART (0-49, 50-99, 100-199, 200-349, 350-499, ?500 cells/µL) overall and separately according to time since start of ART.

Results

A total of 6344 of 37 496 patients died during 359 219 years of follow-up. The MR per 1000 person-years was 32.8 (95% confidence interval [CI], 30.2-35.5) during the first 6 months, declining to 16.0 (95% CI, 15.4-16.8) during 5-9.9 years and 14.2 (95% CI, 13.3-15.1) after 10 years' duration of ART. During the first year of ART, there was a strong inverse association of CD4 count at start of ART with mortality. This diminished over the next 4 years. The adjusted MRR per CD4 group was 0.97 (95% CI, .94-1.00; P = .054) and 1.02 (95% CI, .98-1.07; P = .32) among patients followed for 5-9.9 and ?10 years, respectively.

Conclusions

After surviving 5 years of ART, the mortality of patients who started ART with low baseline CD4 count converged with mortality of patients with intermediate and high baseline CD4 counts.

SUBMITTER: May MT

PROVIDER: S-EPMC4885653 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Publications

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

May Margaret T MT Vehreschild Jorg-Janne JJ Trickey Adam A Obel Niels N Reiss Peter P Bonnet Fabrice F Mary-Krause Murielle M Samji Hasina H Cavassini Matthias M Gill Michael John MJ Shepherd Leah C LC Crane Heidi M HM d'Arminio Monforte Antonella A Burkholder Greer A GA Johnson Margaret M MM Sobrino-Vegas Paz P Domingo Pere P Zangerle Robert R Justice Amy C AC Sterling Timothy R TR Miró José M JM Sterne Jonathan A C JAC Boulle Andrew A Stephan Christoph C Miro Jose M JM Cavassini Matthias M Chêne Geneviève G Costagliola Dominique D Dabis François F Monforte Antonella D'Arminio AD Del Amo Julia J Van Sighem Ard A Fätkenheuer Gerd G Gill John J Guest Jodie J Haerry David Hans-Ulrich DH Hogg Robert R Justice Amy A Shepherd Leah L Obel Neils N Crane Heidi H Smith Colette C Reiss Peter P Saag Michael M Sterling Tim T Teira Ramon R Williams Matthew M Zangerle Robert R Sterne Jonathan J May Margaret M Ingle Suzanne S Trickey Adam A

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20160329 12

<h4>Background</h4>CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterized.<h4>Methods</h4>We estimated mortality rates (MRs) by time since start of ART (<0.5, 0.5-0.9, 1-2.9, 3-4.9, 5-9.9, and ≥10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate c ...[more]

PMID: 27025828

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Dataset Information

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

Background

Methods

Results

Conclusions

Publications

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

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