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dc.contributor.author | May, Margaret T. |
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dc.contributor.author | Vehreschild, Jörg-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 M. |
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 (Domingo Pedrol) |
dc.contributor.author | Zangerle, Robert |
dc.contributor.author | Justice, Amy C. |
dc.contributor.author | Sterling, Timothy R. |
dc.contributor.author | Miró Meda, José M. |
dc.contributor.author | Sterne, Jonathan A. C. |
dc.date | 2017-10-23T13:36:10Z |
dc.date | 2017-10-23T13:36:10Z |
dc.date | 2016-03-29 |
dc.date | 2017-10-23T13:36:10Z |
dc.identifier | 1058-4838 |
dc.identifier | 660553 |
dc.identifier | 27025828 |
dc.identifier.uri | http://hdl.handle.net/2445/116934 |
dc.description | 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. |
dc.format | 7 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | Oxford University Press |
dc.relation | Reproducció del document publicat a: https://doi.org/10.1093/cid/ciw183 |
dc.relation | Clinical Infectious Diseases, 2016, vol. 62, num. 12, p. 1571-1572 |
dc.relation | https://doi.org/10.1093/cid/ciw183 |
dc.rights | cc-by (c) May, Margaret T. et al., 2016 |
dc.rights | http://creativecommons.org/licenses/by/3.0/es |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | VIH (Virus) |
dc.subject | Antiretrovirals |
dc.subject | Morbiditat |
dc.subject | Limfòcits |
dc.subject | HIV (Viruses) |
dc.subject | Antiretroviral agents |
dc.subject | Morbidity |
dc.subject | Lymphocytes |
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 | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/publishedVersion |