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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...
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| Published in: | Antiviral therapy 2012-01, Vol.17 (6), p.1039-1048 |
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| container_title | Antiviral therapy |
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| creator | ZUGNA, Daniela GESKUS, Ronald B DE STAVOLA, Bianca ROSINSKA, Magdalena BARTMEYER, Barbara BOUFASSO, Faroudy CHAIX, Marie-Laure BABIKER, Abdel PORTER, Kholoud |
| description | 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. |
| doi_str_mv | 10.3851/IMP2312 |
| format | article |
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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), or >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.</description><identifier>ISSN: 1359-6535</identifier><identifier>EISSN: 2040-2058</identifier><identifier>DOI: 10.3851/IMP2312</identifier><identifier>PMID: 22910338</identifier><language>eng</language><publisher>London: International Medical Press</publisher><subject>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</subject><ispartof>Antiviral therapy, 2012-01, Vol.17 (6), p.1039-1048</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-452ba12b79f8a6b81bfb9c363e8619d8d671f348372811b8cd5b354b4b5e56403</citedby><cites>FETCH-LOGICAL-c377t-452ba12b79f8a6b81bfb9c363e8619d8d671f348372811b8cd5b354b4b5e56403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26399951$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22910338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ZUGNA, Daniela</creatorcontrib><creatorcontrib>GESKUS, Ronald B</creatorcontrib><creatorcontrib>DE STAVOLA, Bianca</creatorcontrib><creatorcontrib>ROSINSKA, Magdalena</creatorcontrib><creatorcontrib>BARTMEYER, Barbara</creatorcontrib><creatorcontrib>BOUFASSO, Faroudy</creatorcontrib><creatorcontrib>CHAIX, Marie-Laure</creatorcontrib><creatorcontrib>BABIKER, Abdel</creatorcontrib><creatorcontrib>PORTER, Kholoud</creatorcontrib><creatorcontrib>CASCADE Collaboration in EuroCoord</creatorcontrib><creatorcontrib>the CASCADE Collaboration in EuroCoord</creatorcontrib><title>Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection</title><title>Antiviral therapy</title><addtitle>Antivir Ther</addtitle><description>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), or >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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>antiretroviral therapy</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>Chronic Disease - drug therapy</subject><subject>Chronic infection</subject><subject>Confidence Intervals</subject><subject>Data processing</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>HIV - pathogenicity</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Seropositivity - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Proportional Hazards Models</subject><subject>Risk groups</subject><subject>RNA</subject><subject>RNA, Viral - analysis</subject><subject>Seroconversion</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>1359-6535</issn><issn>2040-2058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqFkc-KFDEQh4Mo7riKbyC5iB5szd_u5CiLugMreli9Nkm6shPpTsYkPeKL-LxmmFGPnqoovvoK6ofQU0pecyXpm-3Hz4xTdg9tGBGkY0Sq-2hDudRdL7m8QI9K-UYIU5qQh-iCMU0J52qDft2GBXBN-BBymtNdcGbG3oR5zfAK1wymLhArdjsT7wCbOOEQK-S87mtIEfuU22AKhzCtZi6nDZjwj1B3IWLK8JJi3RWcPL7efsUFcnIpHiCX4_rJ1-w5xeBa68EdvY_RA9908ORcL9GX9-9ur667m08ftldvbzrHh6F2QjJrKLOD9sr0VlHrrXa856B6qic19QP1XCg-MEWpVW6SlkthhZUge0H4JXp58u5z-r5CqeMSioN5NhHSWkbKlCS6vXH4P0qp0JIK0Tf0xQl1OZWSwY_7HBaTf46UjMe8xnNejXx2lq52gekv9yegBjw_A6a0aHw20YXyj-u51u0q_w0mUJ4K</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>ZUGNA, Daniela</creator><creator>GESKUS, Ronald B</creator><creator>DE STAVOLA, Bianca</creator><creator>ROSINSKA, Magdalena</creator><creator>BARTMEYER, Barbara</creator><creator>BOUFASSO, Faroudy</creator><creator>CHAIX, Marie-Laure</creator><creator>BABIKER, Abdel</creator><creator>PORTER, Kholoud</creator><general>International Medical Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20120101</creationdate><title>Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection</title><author>ZUGNA, Daniela ; GESKUS, Ronald B ; DE STAVOLA, Bianca ; ROSINSKA, Magdalena ; BARTMEYER, Barbara ; BOUFASSO, Faroudy ; CHAIX, Marie-Laure ; BABIKER, Abdel ; PORTER, Kholoud</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-452ba12b79f8a6b81bfb9c363e8619d8d671f348372811b8cd5b354b4b5e56403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-HIV Agents - administration & dosage</topic><topic>Anti-HIV Agents - pharmacology</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>antiretroviral therapy</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>Chronic Disease - drug therapy</topic><topic>Chronic infection</topic><topic>Confidence Intervals</topic><topic>Data processing</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>HIV - pathogenicity</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Seropositivity - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Proportional Hazards Models</topic><topic>Risk groups</topic><topic>RNA</topic><topic>RNA, Viral - analysis</topic><topic>Seroconversion</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ZUGNA, Daniela</creatorcontrib><creatorcontrib>GESKUS, Ronald B</creatorcontrib><creatorcontrib>DE STAVOLA, Bianca</creatorcontrib><creatorcontrib>ROSINSKA, Magdalena</creatorcontrib><creatorcontrib>BARTMEYER, Barbara</creatorcontrib><creatorcontrib>BOUFASSO, Faroudy</creatorcontrib><creatorcontrib>CHAIX, Marie-Laure</creatorcontrib><creatorcontrib>BABIKER, Abdel</creatorcontrib><creatorcontrib>PORTER, Kholoud</creatorcontrib><creatorcontrib>CASCADE Collaboration in EuroCoord</creatorcontrib><creatorcontrib>the CASCADE Collaboration in EuroCoord</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Antiviral therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ZUGNA, Daniela</au><au>GESKUS, Ronald B</au><au>DE STAVOLA, Bianca</au><au>ROSINSKA, Magdalena</au><au>BARTMEYER, Barbara</au><au>BOUFASSO, Faroudy</au><au>CHAIX, Marie-Laure</au><au>BABIKER, Abdel</au><au>PORTER, Kholoud</au><aucorp>CASCADE Collaboration in EuroCoord</aucorp><aucorp>the CASCADE Collaboration in EuroCoord</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection</atitle><jtitle>Antiviral therapy</jtitle><addtitle>Antivir Ther</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>17</volume><issue>6</issue><spage>1039</spage><epage>1048</epage><pages>1039-1048</pages><issn>1359-6535</issn><eissn>2040-2058</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Article-2</notes><notes>ObjectType-Feature-1</notes><abstract>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), or >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.</abstract><cop>London</cop><pub>International Medical Press</pub><pmid>22910338</pmid><doi>10.3851/IMP2312</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Sage Journals GOLD Open Access 2024 |
| 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 |
| title | Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection |
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