The prognosis of highly active antiretroviral therapy (HAART) treated HIV infected patients in Serbia,related to the time of treatment initiation |
| |
| Authors: | Dj. Jevtović D. Salemović J. Ranin O. Dulović D. Ilić B. Brmbolić |
| |
| Affiliation: | 1. Hospital for Infectious & Tropical Diseases, University of Belgrade School of Medicine, Belgrade, Serbia;2. Institute for Students Health, Serbia;1. Department of General Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland;2. Departamento Química Orgánica y Química Inorgánica, Universidad de Alcalá, Alcalá de Henares, Spain;3. Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Spain;4. Institute of Biophysics and Cell Engineering of NASB, Minsk, Belarus;5. A.V. Luikov Heat and Mass Transfer Institute of NASB, Minsk, Belarus;6. Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Canada;7. Hotchkiss Brain Institute, University of Calgary, Calgary, Canada;8. Laboratorio de Inmunobiología Molecular, Hospital General Universitario Gregorio Marañón, Madrid, Spain;1. Department of Internal Medicine, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands;2. Nijmegen Institute for Infection, Inflammation, and Immunity (N4i), Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands;3. University of Massachusetts Medical School, 364 Plantation Street, LRB317, Worcester, MA 01605, USA;1. Department of Virology, Royal Free London NHS Foundation Trust, London, United Kingdom;2. Institute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom;1. Saint Michael''s Medical Center, 111 Central Avenue, Newark, NJ 07102, United States;2. Seton Hall University, 400 South Orange Avenue, South Orange, NJ 07079, United States |
| |
| Abstract: | BackgroundWith the introduction of highly active antiretroviral treatment (HAART) an impressive improvement in patient survival and quality of life has bee observed. However, the optimal timing of initial HAART is still under consideration.ObjectiveTo investigate the prognosis of HAART treated patients in Serbia, related to the timing of HAART initiation.Study designA series of 563 patients on HAART was retrospectively analyzed to investigate treatment response and survival.ResultsAfter a mean of 6 years (range 1–14) of treatment with PI-based and/or NNRTI-based regimens, a favorable response was achieved in 72.4%, treatment failure occurred in 7.9%, while 19.7% had a dissociative immunological/virological response. If treatment was initiated during primary HIV infection it took a shorter time to achieve a favorable response than in patients who began HAART in chronic HIV infection (2.7 ± 2.2 years vs. 6.9 ± 2.7 years, P < 0.01). A higher proportion of patients with primary HIV infection then those treated in the chronic phase achieved a favorable response to HAART (88.4% vs. 71.9%, P = 0.045). Patients who initiated HAART when their CD4 cell counts were below 200 cells/μL needed longer treatment for favorable response (8 years vs. 6 years, log rank P < 0.01). Forty-seven (8.3%) patients died. The overall estimated survival was 13 years. Patients older then 40 and IVDU were more likely to die during HAART (OR 2.6, 95% CI 1.1–5.9, P = 0.016, and OR 2.0, 95% CI 1.0–3.7, P = 0.02, respectively). However, reaching and maintaining undetectable viremia was an independent predictor of longer survival (OR 11.3, 95% CI 4.6–27.7, P < 0.01).ConclusionReaching and maintaining undetectable viremia during HAART predicted longer survival, even if sub-clinical immunodeficiency remained. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
