Fungal infection as a risk factor for HIV disease progression among patients with a CD4 count above 200/microl in the era of cART.
Details
Serval ID
serval:BIB_EACBD3A2EB54
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Fungal infection as a risk factor for HIV disease progression among patients with a CD4 count above 200/microl in the era of cART.
Journal
Scandinavian Journal of Infectious Diseases
Working group(s)
Eurosida Study Group
Contributor(s)
Losso M., Duran A., Vetter N., Karpov I., Vassilenko A., Mitsura VM., Suetnov O., Clumeck N., De Wit S., Poll B., Colebunders R., Kostov K., Begovac J., Machala L., Rozsypal H., Sedlacek D., Nielsen J., Lundgren J., Benfield T., Kirk O., Gerstoft J., Katzenstein T., Hansen AB., Skinhøj P., Pedersen C., Oestergaard L., Zilmer K., Smidt J., Ristola M., Katlama C., Viard JP., Girard PM., Livrozet JM., Vanhems P., Pradier C., Dabis F., Rockstroh J., Schmidt R., van Lunzen J., Degen O., Stellbrink HJ., S Staszewski S., J Bogner J., Fatkenheuer G., Kosmidis J., Gargalianos P., Xylomenos G., Perdios J., Panos G., Filandras A., Karabatsaki E., Sambattakou H., Banhegyi D., Mulcahy F., Yust I., Turner D., Burke M., Pollack S., Hassoun G., Maayan S., Chiesi A., Esposito R., Mazeu I., Mussini C., Arici C., Pristera R., Mazzotta F., Gabbuti A., Vullo V., Lichtner M., Chirianni A., Montesarchio E., Gargiulo M., Antonucci G., Iacomi F., Narciso P., Vlassi C., Zaccarelli M., Lazzarin A., Finazzi R., Galli M., Ridolfo A., Monforte£££A d'Arminio£££ Ad. , Rozentale B., Aldins P., Chaplinskas S., Hemmer R., Staub T., Reiss P., J Bruun J., Maeland A., Ormaasen V., Knysz B., Gasiorowsk J., Horban A., Prokopowicz D., Wiercinska-Drapalo A., Boron-Kaczmarska A., Pynka M., Beniowski M., Mularska E., Trocha H., Antunes F., Valadas E., Mansinho K., Maltez F., Duiculescu D., Rakhmanova A., Vinogradova E., Buzunova S., Jevtovic D., Mokras M., Stanekova D., Gonzalez-Lahoz J., Soriano V., Martin-Carbonero L., Labarga P., Clotet B., Jou A., Conejero J., Tural C., Gatell JM., Miro JM., Domingo P., Gutierrez M., Mateo G., Sambeat MA., Karlsson A., Persson PO., Flamholc L., Ledergerber B., Weber R., Francioli P., Cavassini M., Hirschel B., Boffi E., Furrer H., Battegay M., Elzi L., Kravchenko E., Chentsova N., Barton S., Johnson AM., Mercey D., Phillips A., Johnson MA., Mocroft A., Murphy M., Weber J., Scullard G., Fisher M., Brettle R., Clotet B., Antunes F., Clotet B., Duiculescu D., Gatell J., Gazzard B., Horban A., Karlsson A., Katlama C., Ledergerber B., Montforte£££A D'Arminio£££ AD. , Phillips A., Rakhmanova A., Reiss P., Rockstroh J., Lundgren J., Kirk O., Mocroft A., Friis-Møller N., Cozzi-Lepri A., Bannister W., Ellefson M., Borch A., Podlekareva D., Kjaer J., Peters L., Reekie J.
ISSN
0036-5548 (Print)
ISSN-L
0036-5548
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
40
Number
11-12
Pages
908-913
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
The identification of clinical risk factors for AIDS in patients with preserved immune function is of significant interest. We examined whether patients with fungal infection (FI) and CD4 cell count >or=200/microl were at higher risk of disease progression in the era of cART. 11,009 EuroSIDA patients were followed from their first CD4 cell count >or=200/microl after 1 January 1997 until progression to any non-azoles/amphotericin B susceptible (AAS) AIDS disease, last visit or death. Initiation of antimycotic therapy (AMT) was used as a marker of FI and was modelled as a time-updated covariate using Poisson regression. After adjustment for current CD4 cell count, HIV-RNA, starting cART and diagnosis of AAS-AIDS, AMT was significantly associated with an increased incidence of non-AAS-AIDS (IRR=1.55, 95% CI 1.17-2.06, p=0.0024). Despite low incidence of AIDS in the cART era, FI in patients with a CD4 cell count >or=200/microl is associated with a 55% higher risk of non-AAS-AIDS (95% confidence interval 1.17-2.06, p=0.0024). These data suggest that patients with FI are more immune compromized than would be expected from their CD4 cell count alone. FI can be used as a clinical marker for disease progression and indirect indicator for initiation/changing cART in settings where laboratory facilities are limited.
Keywords
Adult, Anti-Retroviral Agents/administration & dosage, Anti-Retroviral Agents/therapeutic use, Antifungal Agents/therapeutic use, CD4 Lymphocyte Count, Disease Progression, Drug Therapy, Combination, Female, HIV Infections/complications, HIV Infections/drug therapy, Humans, Male, Middle Aged, Mycoses/complications, Mycoses/drug therapy, Prospective Studies, Risk Factors
Pubmed
Web of science
Create date
06/03/2009 10:35
Last modification date
20/08/2019 17:13
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