Torres R, Neaton J, Wentworth D, Barr M, Abrams D, Sherer R, Ward T, Sampson J; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 3rd Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 3rd 1996 Wash D C. 1996 Jan 28-Feb 1; 3rd: 121.
Clinical Directors Network, Inc. N.Y., N.Y.
Objective: To evaluate the effect of acyclovir use on survival in HIV seropositive persons enrolled in an observational study by 17 units conducting community-based clinical trials in the United States. Design: Analyses were conducted on 2,368 HIV seropositive persons enrolled 9/90-11/92 visit and followed through 7/94 with CD4+ T-cell counts less than 500/mm 3 who had complete baseline data and attended at least one follow-up visit. Results: 345 (14.5%) reported acyclovir use, and 70.5% reported antiretroviral drug use at baseline. Those using acyclovir at baseline had more advanced HIV disease than those not using acyclovir (mean CD4+ count 148 and 202 cells/mm 3 , respectively) and were more likely to be white, male and gay and have a history of herpes simplex or zoster. A Cox regression analysis found that use of acyclovir at baseline was associated with a non-significant 18% increased risk of death p=.21). Intermittent use of acyclovir was associated with a 48% increased risk of death (p=.004); continuous acyclovir use was not associated with mortality (RR=l.13; p=.38); and "ever" use of acyclovir was associated with a 33% increased risk of death (p=.0004). Use of acyclovir varied markedly by unit, and risk of death varied significantly among 4 groups of units ranked by acyclovir use (P=.04). The unit with the highest acyclovir use (45.5910) had a lower risk of death than the group of units with the lowest use (3.2%), (RR=0.73; P=.03). Conclusion: Use of acyclovir was not associated with improved survival in this large cohort of 2,368 HIV-infected patients, and our findings suggest that intermittent use of acyclovir may be associated with an increased risk of death. Selection biases could have a marked effect on these findings as well as findings from other observational studies.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Acyclovir
- Biomedical Research
- CD4 Lymphocyte Count
- HIV Infections
- HIV Seropositivity
- Herpes Simplex
- Herpes Zoster
- Humans
- Male
- Survival
- United States
- epidemiology
- mortality
Other ID:
UI: 102216418
From Meeting Abstracts