Impact of occasional short interruptions of HAART on the progression of HIV infection: results from a cohort study

Détails

ID Serval
serval:BIB_C43A296FF3C9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Impact of occasional short interruptions of HAART on the progression of HIV infection: results from a cohort study
Périodique
AIDS
Auteur(s)
Taffe  P., Rickenbach  M., Hirschel  B., Opravil  M., Furrer  H., Janin  P., Bugnon  F., Ledergerber  B., Wagels  T., Sudre  P.
ISSN
0269-9370 (Print)
Statut éditorial
Publié
Date de publication
03/2002
Volume
16
Numéro
5
Pages
747-55
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Mar 29
Résumé
OBJECTIVES AND DESIGN: To investigate the clinical consequences of occasional and short (<or= 3 months) treatment interruptions in patients having initiated highly active antiretroviral therapy (HAART). Data from the prospective Swiss HIV Cohort Study were used. METHODS: Four different endpoints [death, Centers for Disease Control and Prevention (CDC) stages B and C, and CD4 cell count increase >or= 50 x 106/l] were studied in relation to the number of interruptions that occurred. In order to focus on short interruptions exclusively, observations of patients with a treatment interruption of > 3 months were censored. The CD4 cell count and viraemia were treated as time-dependent variables because of the importance of these factors when an interruption occurs. RESULTS: Between 1 January 1996 and 31 October 2000, 4720 Swiss HIV Cohort Study participants initiated HAART, which was interrupted at least once by 1299 participants. The main reasons for the interruptions were social factors. Interruptions did not increase significantly the risk of HIV-associated morbidity and mortality, except for a marginally increased risk for a CDC stage C event after the first interruption. The first interruption decreased significantly the likelihood of increasing the CD4 cell count. Subsequent interruptions had no further significant effect. High CD4 cell count and low viraemia, assessed as baseline and as longitudinal variables, were associated with a decreased risk of clinical progression. CONCLUSIONS: Occasional treatment interruptions of < 3 months neither worsen nor improve disease outcome on an average term (3-4 years). Our results suggest that interruptions might be non-risky, particularly when viraemia is low and CD4 cell count is high. These results require confirmation.
Mots-clé
Adult Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Cohort Studies Disease Progression Drug Administration Schedule Female HIV Infections/*drug therapy/immunology/*physiopathology/virology Humans Male Prospective Studies Viremia
Pubmed
Web of science
Création de la notice
29/01/2008 9:52
Dernière modification de la notice
03/03/2018 21:13
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