Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?

Détails

ID Serval
serval:BIB_EECAE37112B1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?
Périodique
AIDS
Auteur(s)
Mocroft A., Laut K., Reiss P., Gatell J., Ormaasen V., Cavassini M., Hadziosmanovic V., Mansinho K., Pradier C., Vasylyev M., Mitsura V., Vandekerckhove L., Ostergaard L., Clarke A., Degen O., Mulcahy F., Castagna A., Sthoeger Z., Flamholc L., Sedláček D., Mozer-Lisewska I., Lundgren J.D.
Collaborateur(s)
EuroSIDA Study
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Statut éditorial
Publié
Date de publication
14/01/2018
Peer-reviewed
Oui
Volume
32
Numéro
2
Pages
205-215
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The extent to which controlled and uncontrolled HIV interact with ageing, European region of care and calendar year of follow-up is largely unknown.
EuroSIDA participants were followed after 1 January 2001 and grouped according to current HIV progression risk; high risk (CD4 cell count ≤350/μl, viral load ≥10 000 copies/ml), low risk (CD4 cell count ≥500 cells/μl, viral load <50 copies/ml) and intermediate (other combinations). Poisson regression investigated interactions between HIV progression risk, age, European region of care and year of follow-up and incidence of AIDS or non-AIDS events.
A total of 16 839 persons were included with 136 688 person-years of follow-up. In persons aged 30 years or less, those at high risk had a six-fold increased incidence of non-AIDS compared with those at low risk, compared with a two-to-three-fold increase in older persons (P = 0.0004, interaction). In Eastern Europe, those at highest risk of non-AIDS had a 12-fold increased incidence compared with a two-to-four-fold difference in all other regions (P = 0.0029, interaction). Those at high risk of non-AIDS during 2001-2004 had a two-fold increased incidence compared with those at low risk, increasing to a five-fold increase between 2013 and 2016 (P < 0.0001, interaction). Differences among high, intermediate and low risk of AIDS were similar across age groups, year of follow-up and Europe (P = 0.57, 0.060 and 0.090, respectively, interaction).
Factors other than optimal control of HIV become increasingly important with ageing for predicting non-AIDS, whereas differences across Europe reflect differences in patient management as well as underlying socioeconomic circumstances. The differences between those at high, intermediate and low risk of non-AIDS between 2013 and 2016 likely reflects better quality of care.
Mots-clé
Acquired Immunodeficiency Syndrome/complications, Acquired Immunodeficiency Syndrome/epidemiology, Adult, Age Factors, Comorbidity, Disease Management, Disease Progression, Europe/epidemiology, Female, Follow-Up Studies, Geography, Humans, Incidence, Male, Middle Aged, Prospective Studies
Pubmed
Web of science
Création de la notice
15/01/2018 18:19
Dernière modification de la notice
06/08/2018 18:00
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