Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection

Estimates of treatment failure, change and interruption are lacking for individuals treated in early HIV infection. Using CASCADE data, we compared the effect of treatment in early infection (within 12 months of seroconversion) with that seen in chronic infection on risk of virological failure, chan...

Full description

Saved in:
Bibliographic Details
Published in:Antiviral therapy 2012-01, Vol.17 (6), p.1039-1048
Main Authors: ZUGNA, Daniela, GESKUS, Ronald B, DE STAVOLA, Bianca, ROSINSKA, Magdalena, BARTMEYER, Barbara, BOUFASSO, Faroudy, CHAIX, Marie-Laure, BABIKER, Abdel, PORTER, Kholoud
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - pharmacology
Antibiotics. Antiinfectious agents. Antiparasitic agents
antiretroviral therapy
Antiviral agents
Biological and medical sciences
CD4 antigen
CD4 Lymphocyte Count
Chronic Disease - drug therapy
Chronic infection
Confidence Intervals
Data processing
Female
Follow-Up Studies
HIV - pathogenicity
HIV Infections - drug therapy
HIV Seropositivity - drug therapy
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious diseases
Lymphocytes T
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Proportional Hazards Models
Risk groups
RNA
RNA, Viral - analysis
Seroconversion
Time Factors
Treatment Failure
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Estimates of treatment failure, change and interruption are lacking for individuals treated in early HIV infection. Using CASCADE data, we compared the effect of treatment in early infection (within 12 months of seroconversion) with that seen in chronic infection on risk of virological failure, change and interruption. Failure was defined as two subsequent measures of HIV RNA>1,000 copies/ml following suppression (500 copies/ml 6 months following initiation. Treatment change and interruption were defined as modification or interruption lasting >1 week. In multivariable competing risks proportional subdistribution hazards models, we adjusted for combination antiretroviral therapy (cART) class, sex, risk group, age, CD4(+) T-cell count, HIV RNA and calendar period at treatment initiation. Of 1,627 individuals initiating cART early (median 1.8 months from seroconversion), 159, 395 and 692 failed, changed and interrupted therapy, respectively. For 2,710 individuals initiating cART in chronic infection (median 35.9 months from seroconversion), the corresponding values were 266, 569 and 597. Adjusted hazard ratios (HRs; 95% CIs) for treatment failure and change were similar between the two treatment groups (0.93 [0.72, 1.20] and 1.06 [0.91, 1.24], respectively). There was an increasing trend in rates of interruption over calendar time for those treated early, and a decreasing trend for those starting treatment in chronic infection. Consequently, compared with chronic infection, treatment interruption was similar for early starters in the early cART period, but the relative hazard increased over calendar time (1.54 [1.33, 1.79] in 2000). Individuals initiating treatment in early HIV infection are more likely to interrupt treatment than those initiating later. However, rates of failure and treatment change were similar between the two groups.
ISSN:1359-6535
2040-2058
DOI:10.3851/IMP2312