Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe

The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated. Patients in EuroSIDA starting at least 1 new antiretroviral drug with CD4500 copies/mL were...

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Bibliographic Details
Published in:PloS one 2014-01, Vol.9 (1), p.e87160
Main Authors: Zoufaly, Alexander, Cozzi-Lepri, Alessandro, Reekie, Joanne, Kirk, Ole, Lundgren, Jens, Reiss, Peter, Jevtovic, Djordje, Machala, Ladislav, Zangerle, Robert, Mocroft, Amanda, Van Lunzen, Jan
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - drug therapy
Acquired Immunodeficiency Syndrome - immunology
Acquired Immunodeficiency Syndrome - virology
Adult
Aged
Aged, 80 and over
AIDS
AIDS (Disease)
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Antiretrovirals
CD4 antigen
CD4 Lymphocyte Count
Cerebrovascular system
Chronic kidney failure
Diabetes
Discordance
Encephalopathy
End-stage renal disease
Europe
Fatalities
Female
Hepatic encephalopathy
Highly active antiretroviral therapy
HIV
HIV (Viruses)
HIV Infections - drug therapy
HIV Infections - immunology
HIV Infections - virology
HIV patients
HIV-1 - drug effects
HIV-1 - physiology
Host-Pathogen Interactions - drug effects
Host-Pathogen Interactions - immunology
Human immunodeficiency virus
Humans
Immune response
Immunosuppression
Immunosupressió
Immunotherapy
Kaplan-Meier Estimate
Kidney diseases
Kidney Failure, Chronic - complications
Kidney transplantation
Liver
Liver diseases
Male
Medicine
Middle Aged
Morbiditat
Morbidity
Mortality
Multivariate Analysis
Neoplasms - complications
Observational studies
Outcome Assessment (Health Care) - methods
Outcome Assessment (Health Care) - statistics & numerical data
Pancreatitis
Patients
Poisson density functions
Prospective Studies
Quality
Regression Analysis
Regression models
Resposta immunitària
Risk
Risk Factors
Statistical analysis
VIH (Virus)
Viral Load - drug effects
Viral Load - immunology
Young Adult
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Summary:The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated. Patients in EuroSIDA starting at least 1 new antiretroviral drug with CD4500 copies/mL were followed-up from the first day of VLgrade 3), cardio- and cerebrovascular events, and end-stage renal disease. Patients were classified over time according to whether current CD4 count was above (non-ID) or below (ID) baseline level. Relative rates (RR) of events were calculated for ID vs. non-ID using adjusted Poisson regression models. 2,913 patients contributed 11,491 person-years for the analysis of non-AIDS. 241 pre-specified non-AIDS events (including 84 deaths) and 89 AIDS events (including 10 deaths) occurred. The RR of developing pre-specified non-AIDS events for ID vs. non-ID was 1.96 (95% CI 1.37-2.81, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0087160