dc.contributor.author |
May, Margaret T. |
dc.contributor.author |
Vehreschild, Jorg-Janne |
dc.contributor.author |
Trickey, Adam |
dc.contributor.author |
Obel, Niels |
dc.contributor.author |
Reiss, Peter |
dc.contributor.author |
Bonnet, Fabrice |
dc.contributor.author |
Mary-Krause, Murielle |
dc.contributor.author |
Samji, Hasina |
dc.contributor.author |
Cavassini, Matthias |
dc.contributor.author |
Gill, Michael John |
dc.contributor.author |
Shepherd, Leah C. |
dc.contributor.author |
Crane, Heidi |
dc.contributor.author |
D'Arminio Monforte, Antonella |
dc.contributor.author |
Burkholder, Greer A. |
dc.contributor.author |
Johnson, Margaret M. |
dc.contributor.author |
Sobrino-Vegas, Paz |
dc.contributor.author |
Domingo, Pere |
dc.contributor.author |
Zangerle, Robert |
dc.contributor.author |
Justice, Amy C. |
dc.contributor.author |
Sterling, Timothy R. |
dc.contributor.author |
Miró, José M. |
dc.contributor.author |
Sterne, Jonathan A. C. |
dc.date |
2016 |
dc.identifier |
https://ddd.uab.cat/record/185833 |
dc.identifier |
urn:10.1093/cid/ciw183 |
dc.identifier |
urn:oai:ddd.uab.cat:185833 |
dc.identifier |
urn:pmid:27025828 |
dc.identifier |
urn:pmcid:PMC4885653 |
dc.identifier |
urn:pmc-uid:4885653 |
dc.identifier |
urn:articleid:15376591v62p1571 |
dc.identifier |
urn:oai:egreta.uab.cat:publications/88c8e2f9-88df-41d8-98be-fc8625e9aec4 |
dc.identifier |
urn:scopus_id:84973483975 |
dc.identifier |
urn:oai:pubmedcentral.nih.gov:4885653 |
dc.format |
application/pdf |
dc.language |
eng |
dc.publisher |
|
dc.relation |
Instituto de Salud Carlos III ISCIII-RETIC RD06-00 |
dc.relation |
Clinical Infectious Diseases ; Vol. 62 (march 2016), p. 1571-1577 |
dc.rights |
open access |
dc.rights |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
dc.rights |
https://creativecommons.org/licenses/by/4.0/ |
dc.subject |
HIV |
dc.subject |
CD4 count |
dc.subject |
Antiretroviral therapy |
dc.subject |
Mortality |
dc.subject |
Cohort collaboration |
dc.title |
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 |
dc.type |
Article |
dc.description.abstract |
The strong association of CD4 count at start of combination therapy with subsequent survival in HIV-infected patients diminished during the first 5 years of treatment. After 5 years, lower baseline CD4 counts were not associated with higher mortality. 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. |