{"id":1761,"date":"2008-02-01T08:47:20","date_gmt":"2008-02-01T07:47:20","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=1761"},"modified":"2013-08-30T11:23:08","modified_gmt":"2013-08-30T11:23:08","slug":"hiv-positive-adults-with-cd4-500-cellsmm3-have-similar-mortality-rates-as-the-general-population-after-seven-years-arv-treatment","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/1761","title":{"rendered":"HIV-positive adults with CD4 >500 cells\/mm3 have similar mortality rates as the general population after seven years ARV treatment"},"content":{"rendered":"<p><strong>Charlotte Lewden and colleagues published an analysis of life-expectancy in a subgroup of patients on long-term PI-based HAART, from two French cohorts, in the September 2007 edition of JAIDS.<\/strong><\/p>\n<p>A total of 2435 patients the Aproco-Copilote and Aquitaine cohorts, who started protease inhibitor-based combination therapy during 1997-1999, were included in the analysis. There was a median follow-up of 6.8 years since starting combination therapy (IQR 4.1 to 7.9, 13,970 patient years (PYs). Standardised mortality ratios (SMR\u0092s) were compared to the general population. [1]<\/p>\n<p>Baseline demographics included 77% men, median age 36, and median CD4 count 270 cells\/mm<sup>3<\/sup>. 16% of patients had a CD4 cell count =500 cells\/mm<sup>3<\/sup>, and 19% of patients had a CD4 cell count between 350 and 499 cells\/mm<sup>3<\/sup>. 21% transmission by IDU. 29% of patients were HCV infected (88% among patients infected through injecting drug use. 39% patients had previously been prescribed mono or dual therapy.<\/p>\n<p>After adjusting for age and gender, overall mortality remained 7-fold higher in HIV-infected adults than in the general population (95% confidence interval [CI]: 6.2 to 7.8). Mortality was 4.8 in men and 13.0 in women, 16.3 in injecting drug users, and 13.9 in HCV-coinfected patients.<\/p>\n<p>SMRs were also estimated according to HIV transmission group (injecting drug use vs. others) and hepatitis C virus (HCV) coinfection as defined by the presence of HCV antibody or plasma HCV RNA at baseline, because similar types of analyses reported higher mortality ratios in these groups.<\/p>\n<p>However, mortality rates became similar to that of the general population after the sixth year of follow-up among patients whose CD4 counts had reached 500 cells\/mm<sup>3<\/sup> (49% of the 1430 patients still followed at 6 years, SMR 0.5, 95% CI: 0.1 to 1.6).<\/p>\n<p>The authors concluded that these results remain to be confirmed in other populations, and cohort collaborations may address this question with a larger sample size and a longer follow-up.<\/p>\n<p>Identifying this good prognosis for patients achieving CD4 counts &gt;500 cells\/mL on stable long-term treatment was suggested as evidence of the important of starting treatment while such a CD4 response could be expected.<\/p>\n<p>This study was presented in part at the EACS conference in Dublin two years ago.<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">Lewden C et al for ANRS APROCO-COPILOTE and CO3 AQUITAINE Study Groups. HIV-Infected Adults With a CD4 Cell Count Greater Than 500 Cells\/mm<sup>3<\/sup> on Long-Term HAART Reach Same Mortality Rates as the General Population. JAIDS Journal of Acquired Immune Deficiency Syndromes: Volume 46(1)1 September 2007pp 72-77.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Charlotte Lewden and colleagues published an analysis of life-expectancy in a subgroup of patients on long-term PI-based HAART, from two French cohorts, in the September 2007 edition of JAIDS. A total of 2435 patients the Aproco-Copilote and Aquitaine cohorts, who &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-1761","post","type-post","status-publish","format-standard","hentry","category-antiretrovirals"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/1761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=1761"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/1761\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=1761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=1761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=1761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}