Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Swiss HIV Cohort Study

Details

Serval ID
serval:BIB_D9A844DF0406
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Swiss HIV Cohort Study
Journal
Lancet
Author(s)
Ledergerber  B., Egger  M., Opravil  M., Telenti  A., Hirschel  B., Battegay  M., Vernazza  P., Sudre  P., Flepp  M., Furrer  H., Francioli  P., Weber  R.
ISSN
0140-6736 (Print)
Publication state
Published
Issued date
03/1999
Volume
353
Number
9156
Pages
863-8
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Mar 13
Abstract
BACKGROUND: The efficacy of highly active antiretroviral therapy (HAART) in suppression of HIV-1 is well documented. We investigated virological and clinical outcomes of HAART in routine practice. METHODS: We analysed prospective data from the Swiss HIV Cohort Study on suppression of viral load and progression to AIDS or death in 2674 outpatients (median age 36 years, 27.3% women) who started HAART in 1995-98. Viral rebound was defined as two consecutive HIV-1-RNA measurements of more than 400 copies/mL. We analysed separately outcomes in patients with a history of antiretroviral treatment and in treatment-naive patients. FINDINGS: An estimated 90.7% of treatment-naive patients reached undetectable viral load (<400 copies/mL) by 12 months. Among pretreated patients, estimates ranged from 70.3% treated with one new drug to 78.7% on three new drugs. 2 years after reaching undetectable concentrations, an estimated 20.1% of treatment-naive patients and 35.7-40.1% of pretreated patients had viral rebound. At 30 months, an estimated 6.6% (95% CI 4.6-8.6) of patients who had maintained undetectable concentrations, 9.0% (5.5-12.5) who had viral rebound, and 20.1% (15.3-24.9) who had never reached undetectable concentrations developed AIDS or died. Compared with patients who maintained undetectable viral load, the adjusted relative hazard of AIDS or death was 1.00 (0.66-1.55) for patients with viral rebound, and 2.40 (1.72-3.33) for patients who failed to reach undetectable concentrations. INTERPRETATION: The rate of virological failure of HAART was high among these patients, but the probability of clinical progression was low even in patients with viral rebound.
Keywords
Adult Aged Aged, 80 and over Anti-HIV Agents/administration & dosage/*therapeutic use CD4 Lymphocyte Count/drug effects Disease Transmission, Horizontal Drug Therapy, Combination Female HIV Infections/*drug therapy/transmission *HIV-1/isolation & purification Humans Life Tables Male Middle Aged Probability Prospective Studies RNA, Viral/isolation & purification Switzerland Treatment Failure Viral Load
Pubmed
Web of science
Create date
25/01/2008 17:07
Last modification date
20/08/2019 15:58
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