When to initiate combined antiretroviral therapy to reduce mortality and AIDS-defining illness in HIV-infected persons in developed countries: an observational study.
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Serval ID
serval:BIB_54A374FD3C41
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
When to initiate combined antiretroviral therapy to reduce mortality and AIDS-defining illness in HIV-infected persons in developed countries: an observational study.
Journal
Annals of internal medicine
Working group(s)
HIV-CAUSAL Collaboration
Contributor(s)
Ainsworth J., Anderson J., Babiker A., Delpech V., Dunn D., Easterbrook P., Fisher M., Gazzard B., Gilson R., Gompels M., Hill T., Johnson M., Leen C., Orkin C., Phillips A., Pillay D., Porter K., Sabin C., Schwenk A., Walsh J., Bansi L., Hill T., Phillips A., Sabin C., Dunn D., Porter K., Glabay A., Orkin C., Thomas R., Jones K., Fisher M., Perry N., Pullin A., Churchill D., Gazzard B., Nelson M., Asboe D., Bulbeck S., Mandalia S., Clarke J., Delpech V., Anderson J., Munshi S., Post F., Easterbrook P., Khan Y., Patel P., Karim F., Duffell S., Gilson R., Man S.L., Williams I., Gompels M., Dooley D., Schwenk A., Ainsworth J., Johnson M., Youle M., Lampe F., Smith C., Grabowska H., Chaloner C., Ismajani Puradiredja D., Bansi L., Hill T., Phillips A., Sabin C., Walsh J., Weber J., Kemble C., Mackie N., Winston A., Leen C., Wilson A., de Wolf F., Bezemer D.O., Gras L.A., Kesselring A.M., van Sighem A.I., Smit C., Zhang S., Zaheri S., Prins J.M., Boer K., Bos J.C., Geerlings S.E., Godfried M.H., Haverkort M.E., Kuijpers T.W., Lange J.M., van der Meer J.T., Nellen F.J., Pajkrt D., van der Poll T., Reiss P., Scherpbier H.J., van der Valk M., Vrouenraets S.M., van Vugt M., Wit F.W., Schreij G., Lowe S., Oude Lashof A., Bravenboer B., Pronk M.J., van der Ende M.E., van der Feltz M., Gelinck L.B., Nouwen J.L., Rijnders B.J., de Ruiter E.D., Slobbe L., Schurink C.A., Verbon A., de Vries-Sluijs T.E., Driessen G., Hartwig N.G., Branger J., Kauffmann R.H., Schippers E.F., Groeneveld P.H., Alleman M.A., Bouwhuis J.W., ten Kate R.W., Soetekouw R., Kroon F.P., Arend S.M., de Boer M.G., van den Broek P.J., van Dissel J.T., Jolink H., van Nieuwkoop C., den Hollander J.G., Pogany K., Bronsveld W., Kortmann W., van Twillert G., Vriesendorp R., Leyten E.M., van Houte D., Polee M.B., van Vonderen M.G., ten Napel C.H., Kootstra G.J., Brinkman K., van den Berk G.E., Blok W.L., Frissen P.H., Schouten W.E., van Eeden A., Verhagen D.W., Mulder J.W., van Gorp E.C., Smit P.M., Weijer S., Juttmann J.R., Brouwer A.E., van Kasteren M.E., Veenstra J., Lettinga K.D., Koopmans P.P., Brouwer A.M., Dofferhoff A.S., van der Flier M., de Groot R., ter Hofstede H.J., Keuter M., van der Ven A.J., Sprenger H.G., van Assen S., Doedens R., Scholvinck E.H., Stek C.J., Hoepelman A.I., Arends J.E., Ellerbroek P.M., van der Hilst J.C., Jaspers C.A., Maarschalk-Ellerbroek L.J., Oosterheert J.J., Peters E.J., Mudrikova T., Schneider M.M., Wassenberg M.W., Geelen S.P., Wolfs T.F., Danner S.A., van Agtmael M.A., Bierman W.F., Claessen F.A., de Jong E.V., Kortmann W., Perenboom R.M., bij de Vaate E.A., Richter C., van der Berg J., Gisolf E.H., van den Berge M., Stegeman A., Duits A.J., Winkel K., Abgrall S., Barin F., Bentata M., Billaud E., Boue F., Burty C., Cabie A., Costagliola D., Cotte L., De Truchis P., Duval X., Duvivier C., Enel P., Fredouille-Heripret L., Gasnault J., Gaud C., Gilquin J., Grabar S., Katlama C., Khuong M.A., Lang J.M., Lascaux A.S., Launay O., Mahamat A., Mary-Krause M., Matheron S., Meynard J.L., Pavie J., Pialoux G., Pilorge F., Poizot-Martin I., Pradier C., Reynes J., Rouveix E., Simon A., Tattevin P., Tissot-Dupont H., Viard J.P., Viget N., Salomon V., Jacquemet N., Abgrall S., Costagliola D., Grabar S., Guiguet M., Lanoy E., Lievre L., Mary-Krause M., Selinger-Leneman H., Lacombe J.M., Potard V., Bricaire F., Herson S., Katlama C., Simon A., Desplanque N., Girard P.M., Meynard J.L., Meyohas M.C., Picard O., Cadranel J., Mayaud C., Pialoux G., Clauvel J.P., Decazes J.M., Gerard L., Molina J.M., Diemer M., Sellier P., Bentata M., Honore P., Jeantils V., Tassi S., Mechali D., Taverne B., Bouvet E., Crickx B., Ecobichon J.L., Matheron S., Picard-Dahan C., Yeni P., Berthe H., Dupont C., Chandemerle C., Mortier E., de Truchis P., Tisne-Dessus D., Weiss L., Salmon D., Auperin I., Gilquin J., Roudiere L., Viard J.P., Boue F., Fior R., Delfraissy J.F., Goujard C., Jung C., Lesprit P., Vittecoq D., Fraisse P., Lang J.M., Rey D., Beck-Wirth G., Stahl J.P., Lecercq P., Gourdon F., Laurichesse H., Fresard A., Lucht F., Bazin C., Verdon R., Chavanet P., Arvieux C., Michelet C., Choutet P., Goudeau A., Maiotre M.F., Hoen B., Eglinger P., Faller J.P., Borsa-Lebas F., Caron F., Reynes J., Daures J.P., May T., Rabaud C., Berger J.L., Remy G., Arlet-Suau E., Cuzin L., Massip P., Thiercelin Legrand M.F., Pontonnier G., Viget N., Yasdanpanah Y., Dellamonica P., Pradier C., Pugliese P., Aleksandrowicz K., Quinsat D., Ravaux I., Tissot-Dupont H., Delmont J.P., Moreau J., Gastaut J.A., Poizot-Martin I., Retornaz F., Soubeyrand J., Galinier A., Ruiz J.M., Allegre T., Blanc P.A., Bonnet-Montchardon D., Lepeu G., Granet-Brunello P., Esterni J.P., Pelissier L., Cohen-Valensi R., Nezri M., Chadapaud S., Laffeuillade A., Billaud E., Raffi F., Boibieux A., Peyramond D., Livrozet J.M., Touraine J.L., Cotte L., Trepo C., Strobel M., Bissuel F., Pradinaud R., Sobesky M., Cabie A., Gaud C., Contant M., Aebi C., Battegay M., Bernasconi E., Boni J., Brazzola P., Bucher H.C., Burgisser P., Calmy A., Cattacin S., Cavassini M., Cheseaux J.J., Drack G., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H.J., Fux C., Gayet-Ageron A., Gerber S., Gorgievski M., Gunthard H., Gyr T., Hirsch H., Hirschel B., Hosli I., Husler M., Kaiser L., Kahlert C., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Muller N., Nadal D., Paccaud F., Pantaleo G., Raio L., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schupbach J., Speck R., Taffe P., Telenti A., Trkola A., Vernazza P., Weber R., Wyler C.A., Yerly S., Casabona J., Miro J.M., Alquezar A., Isern V., Casabona J., Esteve A., Alquezar A., Miro J.M., Podzamczer D., Murillas J., Gatell J.M., Aguero F., Tural C., Clotet B., Ferrer E., Riera M., Segura F., Navarro G., Force L., Vilaro J., Masabeu A., Garcia I., Guadarrama M., Romero A., Agusti C., Esteve A., Montoliu A., Ortega N., Lazzari E., Puchol E., Sanchez M., Blanco J.L., Garcia-Alcaide F., Martinez E., Mallolas J., Lopez-Dieguez M., Garcia-Goez J.F., Sirera G., Romeu J., Jou A., Negredo E., Miranda C., Capitan M.C., Olmo M., Barragan P., Saumoy M., Bolao F., Cabellos C., Pena C., Sala M., Cervantes M., Jose Amengual M., Navarro M., Penelo E., Barrufet P., Guadarrama M., Berenguer J., del Amo J., Garcia F., Gutierrez F., Labarga P., Moreno S., Munoz M.A., Caro-Murillo A.M., Sobrino P., Jarrin I., Gomez Sirvent J.L., Rodriguez P., Aleman M.R., Alonso M.M., Lopez A.M., Hernandez M.I., Soriano V., Labarga P., Barreiro P., Medrano J., Rivas P., Herrero D., Blanco F., Vispo M.E., Martin L., Ramirez G., de Diego M., Rubio R., Pulido F., Moreno V., Cepeda C., Hervas R.L., Iribarren J.A., Arrizabalaga J., Aramburu M.J., Camino X., Rodriguez-Arrondo F., von Wichmann M.A., Pascual L., Goenaga M.A., Gutierrez F., Masia M., Ramos J.M., Padilla S., Sanchez-Hellin V., Bernal E., Escolano C., Montolio F., Peral Y., Berenguer J., Lopez J.C., Miralles P., Cosin J., Sanchez M., Gutierrez I., Ramirez M., Padilla B., Vidal F., Sanjuan M., Peraire J., Veloso S., Vilades C., Lopez-Dupla M., Olona M., Vargas M., Aldeguer J.L., Blanes M., Lacruz J., Salavert M., Montero M., Cuellar S., de los Santos I., Sanz J., Oteo J.A., Blanco J.R., Ibarra V., Metola L., Sanz M., Perez-Martinez L., Sola J., Uriz J., Castiello J., Reparaz J., Arriaza M.J., Irigoyen C., Moreno S., Antela A., Casado J.L., Dronda F., Moreno A., Perez M.J., Lopez D., Gutierrez C., Hernandez B., Pumares M., Marti P., Garcia L., Page C., Garcia F., Hernandez J., Pena A., Munoz L., Parra J., Viciana P., Leal M., Lopez-Cortes L.F., Trastoy M., Mata R., Justice A.C., Fiellin D.A., Mattocks K., Braithwaite S., Brandt C., Bryant K., Cook R., Conigliaro J., Crothers K., Chang J., Crystal S., Day N., Erdos J., Freiberg M., Kozal M., Gandhi N., Gaziano M., Gerschenson M., Good B., Gordon A., Goulet J.L., Hernan M.A., Kraemer K., Lim J., Maisto S., Miller P., Mole L., O'Connor P., Papas R., Robins J.M., Rinaldo C., Roberts M., Samet J., Tierney B., Whittle J., Rimland D., Jones-Taylor C., Oursler K.A., Titanji R., Brown S., Garrison S., Rodriguez-Barradas M., Masozera N., Goetz M., Leaf D., Simberkoff M., Blumenthal D., Leung J., Butt A., Hoffman E., Gibert C., Peck R., Phillips A., Babiker A., Brettle R., Darbyshire J., Delpech V., Easterbrook P., Fidler S., Fisher M., Gilson R., Goldberg D., Hawkins D., Jaffe H., Johnson A., Johnson M., McLean K., Pillay D., Porter K., Cursley A., Ewings F., Fairbrother K., Gnatiuc L., Lodi S., Murphy B., Smit E., Ward F., Douglas G., Kennedy N., Pritchard J., Andrady U., Rajda N., Maw R., McKernan S., Drake S., Gilleran G., White D., Ross J., Toomer S., Hewart R., Wilding H., Woodward R., Dean G., Heald L., Horner P., Glover S., Bansaal D., Eduards S., Carne C., Browing M., Das R., Stanley B., Estreich S., Magdy A., O'Mahony C., Fraser P., Hayman B., Jebakumar S.P., Joshi U., Ralph S., Wade A., Mette R., Lalik J., Summerfield H., El-Dalil A., France A.J., White C., Robertson R., Gordon S., McMillan S., Morris S., Lean C., Morris S., Vithayathil K., McLean L., Winter A., Gale D., Jacobs S., Goorney B., Howard L., Tayal S., Short L., Roberts M., Green S., Williams G., Sivakumar K., Bhattacharyya D.N., Monteiro E., Minton J., Dhar J., Nye F., DeSouza C.B., Isaksen A., McDonald L., McLean K., Franca A., Hawkins D., William L., Jendrulek I., Peters B., Shaunak S., El-Gadi S., Easterbrook P.J., Mazhude C., Gilson R., Johnstone R., Fakoya A., Mchale J., Waters A., Kegg S., Mitchell S., Byrne P., Johnson M., Rice P., Fidler S., Mullaney S.A., McCormack S., David D., Melville R., Phillip K., Balachandran T., Mabey S., Sukthankar A., Murphy C., Wilkins E., Ahmad S., Tayal S., Haynes J., Evans E., Ong E., Das R., Grey R., Meaden J., Bignell C., Loay D., Peacock K., Girgis M.R., Morgan B., Palfreeman A., Wilcox J., Tobin J., Tucker L., Saeed A.M., Chen F., Deheragada A., Williams O., Lacey H., Herman S., Kinghorn D., Devendra S.V., Wither J., Dawson S., Rowen D., Harvey J., Wilkins E., Bridgwood A., Singh G., Chauhan M., Kellock D., Young S., Dannino S., Kathir Y., Rooney G., Currie J., Fitzgerald M., Devendra S., Keane F., Booth G., Green T., Arumainayyagam J., Chandramani S., Rajamanoharan S., Robinson T., Curless E., Gokhale R., Tariq A., Roberts M., Williams O., Luzzi G., FitzGerald M., Fairley I., Wallis F., Molina J.M., Loze B., Sereni D., Lascoux C., Prevoteau F., Morel P., Timsit J., Oksenhendeler E., Gerard L., Morlat P., Bonarek M., Bonnet F., Nouts C., Louis I., Raffi F., Reliquet V., Sauser F., Biron C., Mounoury O., Hue H., Brosseau D., Delfraissy J.F., Goujard C., Ghosn J., Rannou M.T., Bergmann J.F., Badsi E., Rami A., Diemer M., Parrinello M., Girard P.M., Samanon-Bollens D., Campa P., Tourneur M., Desplanques N., Cabane J., Picard O., Tredup J., Desplanques N., Herriot E., Livrozet J.M., Jeanblanc F., Chiarello P., Makhloufi D., Blanc A.P., Allegre T., Reynes J., Baillat V., Lemoing V., Merle de Boever C., Tramoni C., Cabie A., Sobesky G., Abel S., Beaujolais V., Pialoux G., Slama L., Chakvetadze C., Berrebi V., Yeni P., Bouvet E., Fournier I., Gerbe J., Leport C., Jadand C., Jestin C., Longuet P., Boucherit S., Trepo C., Koffi K., Augustin-Normand C., Miailhes P., Thoirain V., Brochier C., Thomas R., Souala F., Ratajczak M., Montpied G., Beytoux J., Jacomet C., Gourdon F., Pare A., Rouveix E., Morelon S., Dupont C., Olivier C., Lortholary O., Dupont B., Viard J.P., Maignan A., Ragnaud J.M., Raymond I., Mondor H., Sobel A., Levy Y., Lelievre J.D., Lascaux A.S., Dominguez S., Dumont C., Aumaitre H., Delmas B., Saada M., Medus M., Guillevin L., Salmon D., Tahi T., Yazdanpanah Y., Pavel S., Marien M.C., Muller E., Drenou B., Beck-Wirth G., Beck C., Benomar M., Katlama C., Tubiana R., Ait Mohand H., Chermak A., Ben Abdallah S., Herson S., Amirat N., Simon A., Brancion C., Bentata M., Touam F., Hoen B., Drobacheff C., Folzer A., Massip P., Obadia M., Prudhomme L., Bonnet E., Balzarin F., Pichard E., Chennebault J.M., Fialaire P., Loison J., Galanaud P., Boue F., Bornarel D., Verdon R., Bazin C., Six M., Ferret P., Weiss L., Batisse D., Gonzales-Canali G., Tisne-Dessus D., Devidas A., Chevojon P., Turpault I., Lafeuillade A., Cheret A., Philip G., Stein A., Ravault I., Chavanet C., Buisson M., Treuvetot S., Choutet P., Nau P., Bastides F., May T., Boyer L., Wassoumbou S., Bernard L., De Truchis P., Berthe H., Domart Y., Merrien D., Mignot A., Greder Belan A., Gayraud M., Bodard L., Meudec A., Beuscart C., Daniel C., Pape E., Mourier L., Vinceneux P., Simonpoli A.M., Zeng A., Jacquet M., Fournier L., Fuzibet J.G., Sohn C., Rosenthal E., Quaranta M., Dellamonica P., Chaillou S., Sabah M., Pasteur L., Audhuy B., Schieber A., Moreau P., Niault M., Vaillant O., Huchon G., Compagnucci A., De Lacroix Szmania I., Richier L., Lamaury I., Saint-Dizier F., Garipuy D., Gastaut J.A., Drogoul M.P., Poizot Martin I., Fabre G., Lambert de Cursay G., Abraham B., Perino C., Lagarde P., David F., Veil S., Roche-Sicot J., Saraux J.L., Lepretre A., Fampin B., Uludag A., Morin A.S., Bletry O., Zucman D., Regnier A., Girard J.J., Quinsat D.T., Heripret L., Grihon F., Houlbert D., Ruel M., Chemlal K., Nicolle C., Caron F., Debab Y., Tremollieres F., Perronne V., Duffaut H., Lepeu G., Slama B., Perre P., Miodovski C., Guermonprez G., Dulioust A., Ballanger R., Boudon P., Malbec D., Patey O., Semaille C., Deville J., Remy G., Beguinot I., Galanaud P., Boue F., Chambrin V., Pignon C., Estocq G.A., Levy A., Delfraissy J.F., Goujard C., Duracinsky M., Le Bras P., Ngussan M.S., Peretti D., Medintzeff N., Lambert T., Segeral O., Lezeau P., Laurian Y., Weiss L., Buisson M., Piketty C., Karmochkine M., Batisse D., Eliaszewitch M., Jayle D., Tisne-Dessus D., Kazatchkine M., Leport C., Colasante U., Jadand C., Jestin C., Duval X., Nouaouia W., Boucherit S., Vilde J.L., Girard P.M., Bollens D., Binet D., Diallo B., Meyohas M.C., Fonquernie L., Lagneau J.L., Salmon D., Guillevin L., Tahi T., Launay O., Pietrie M.P., Sicard D., Stieltjes N., Michot J., Sobel A., Levy Y., Bourdillon F., Lascaux A.S., Lelievre J.D., Dumont C., Dupont B., Obenga G., Viard J.P., Maignan A., Vittecoq D., Escaut L., Bolliot C., Bricaire F., Katlama C., Schneider L., Herson S., Simon A., Iguertsira M., Stein A., Tomei C., Ravaux I.
ISSN
1539-3704 (Electronic)
ISSN-L
0003-4819
Publication state
Published
Issued date
19/04/2011
Peer-reviewed
Oui
Volume
154
Number
8
Pages
509-515
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 10(9) cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate.
To identify the optimal CD4 cell count at which cART should be initiated.
Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 10(9) cells/L.
HIV clinics in Europe and the Veterans Health Administration system in the United States.
20, 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 10(9) cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 10(9) cells/L and were included in the analysis.
Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death.
Compared with initiating cART at the CD4 cell count threshold of 0.500 × 10(9) cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death.
CD4 cell count at cART initiation was not randomized. Residual confounding may exist.
Initiation of cART at a threshold CD4 count of 0.500 × 10(9) cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 × 10(9) cells/L.
To identify the optimal CD4 cell count at which cART should be initiated.
Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 10(9) cells/L.
HIV clinics in Europe and the Veterans Health Administration system in the United States.
20, 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 10(9) cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 10(9) cells/L and were included in the analysis.
Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death.
Compared with initiating cART at the CD4 cell count threshold of 0.500 × 10(9) cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death.
CD4 cell count at cART initiation was not randomized. Residual confounding may exist.
Initiation of cART at a threshold CD4 count of 0.500 × 10(9) cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 × 10(9) cells/L.
Keywords
Acquired Immunodeficiency Syndrome/drug therapy, Acquired Immunodeficiency Syndrome/immunology, Acquired Immunodeficiency Syndrome/mortality, Anti-Retroviral Agents/administration & dosage, Anti-Retroviral Agents/therapeutic use, CD4 Lymphocyte Count, Cause of Death, Developed Countries, Disease Progression, Drug Administration Schedule, Drug Therapy, Combination, HIV Infections/drug therapy, HIV Infections/immunology, HIV Infections/mortality, Humans, Observation, Proportional Hazards Models, Prospective Studies
Pubmed
Web of science
Create date
29/12/2011 16:11
Last modification date
20/08/2019 14:09