van Sighem AI, Ghani AC, Gras L, Danner S, Anderson RM, de Wolf F; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).

Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. MoPeC3379.

HIV Monitoring Foundation, Amsterdam, Netherlands

Background: We developed a prognostic model using the initial immunological and virological response in patients starting HAART. Methods: Antiretroviral therapy naive patients initiating HAART were selected from the ATHENA observational cohort, excluding patients infected via intravenous drug use or with less than 24 weeks of follow-up. Endpoint of the study was the time of death. The most recent CD4 cell count and HIV-RNA load within 24 weeks before start of HAART (T[0]) and corresponding measurements closest to 24 weeks after T[0], within 12 to 36 weeks, were determined. Cox proportional hazards model was used to model survival probabilities. Poisson's distribution was used to calculate 95% confidence intervals (CI) for mortality rates. Expected death rates were calculated for age and gender matched groups from the general Dutch population. Results: 91 of 3057 patients died during 11459 person-years of follow-up. Among the 871 (28.5%) patients initiating HAART before 1998 (early HAART), mortality rates ranged from 1.84 (CI 1.11-2.88; expected 0.28) per 100 person-years for patients with less than 200 x 10[6] CD4 cells/l at 24 weeks to 0.59 (CI 0.27-1.13; 0.26) if CD4 counts exceeded 500 x 10[6] cells/l, whilst these rates were 1.17 (CI 0.70-1.82; 0.23) and 0.18 (CI 0.04-0.52; 0.21), respectively, for patients starting HAART in or after 1998 (late HAART). The only covariates found to be associated with a higher survival probability were a log transformed CD4 count at 24 weeks (hazard ratio (HR) 0.49, CI 0.39-0.62, per unit increase) and starting late versus early HAART (HR 0.49, CI 0.32-0.76). Predicted and measured five-year survival probabilities were above 94% if 24-week CD4 counts exceeded 200 x 10[6] cells/l. Conclusions: Five-year survival probabilities in a group of patients with a good initial response to HAART are high. Moreover, mortality rates are comparable to those in the general non-HIV-infected Dutch population.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• HIV Infections
• HIV Seropositivity
• Humans
• Proportional Hazards Models
• Substance Abuse, Intravenous
• Survival
• Survival Analysis
• Treatment Outcome

Other ID:

• GWAIDS0035464

UI: 102279680

From Meeting Abstracts