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Association of Virus Load, CD4 Cell Count, and Treatment with Clinical Progression in Human Immunodeficiency Virus-Infected Patients with Very Low CD4 Cell Counts

Miller, Veronica ; Phillips, Andrew N. ; Clotet, Bonaventura ; Mocroft, Amanda ; Ledergerber, Bruno ; Kirk, Ole ; Ormaasen, Vidar ; Gargalianos-Kakolyris, Panagiotis ; Vella, Stefano ; Lundgren, Jens D.

In: The Journal of Infectious Diseases, 2002, vol. 186, no. 2, p. 189-197

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    Title
    • Association of Virus Load, CD4 Cell Count, and Treatment with Clinical Progression in Human Immunodeficiency Virus-Infected Patients with Very Low CD4 Cell Counts
    Author
    • Miller, Veronica. Klinikum der Johann Wolfgang Goethe-Universität, Zentrum der Inneren Medizin, Frankfurt, Germany
    • Phillips, Andrew N.. Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, United Kingdom
    • Clotet, Bonaventura. Fundaciò irsi Caixa, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
    • Mocroft, Amanda. Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, United Kingdom
    • Ledergerber, Bruno. Division of Infectious Diseases, University Hospital Zurich, Switzerland
    • Kirk, Ole. Hvidovre Hospital, University of Copenhagen, Denmark
    • Ormaasen, Vidar. Department of Infectious Diseases, Ullevål Hospital, Oslo, Norway
    • Gargalianos-Kakolyris, Panagiotis. Special Infectious Unit, First Department of Medicine, General Hospital of Athens, Athens, Greece
    • Vella, Stefano. Laboratory of Virology, Instituto Superiore di Sanità, Rome, Italy
    • Lundgren, Jens D.. Hvidovre Hospital, University of Copenhagen, Denmark
    Document Type
    • Postprint
    Language
    • English
    Published in
    • The Journal of Infectious Diseases, 2002, vol. 186, no. 2, p. 189-197. The University of Chicago Press
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:294076
    Summary
    This study prospectively assessed the impact of treatment modality, virus load, and CD4 cell count of <50 cells/mm3 on human immunodeficiency virus disease progression. The incidence rate of new AIDS disease or death was 54.8 (95% confidence interval, 48.7-59.9) per 100 person-years of follow-up. Independent predictors related to progression were latest CD4 cell count (relative risk [RR], 0.84/10 mm3 higher; P<.0001), latest hemoglobin level (RR, 0.79/g/L higher; P<.0001), Pneumocystis carinii pneumonia prophylaxis (RR, 0.49; P<.0001), latest body mass index (RR, 0.93/kg/m2 higher; P=.002), latest virus load (RR, 1.11/log10 higher; P=.03), and intensity of treatment (RR, 1.82, P=.004; RR 2.27, P<.0001; RR 2.46, P=.0001; RR 2.33 P<.0006; 5.10, P<.0001, respectively, for 4, 3, 2, 1, or no drugs vs. ⩾5 drugs). Although reverse causality cannot be excluded, more intense antiviral treatment appears to decrease the risk of progression in immunocompromised patients