The risk of clinical progression for human immunodeficiency virus (HIV)-infected persons receiving treatment with highly active antiretroviral therapy (HAART) is poorly defined. From an inception cohort of 8457 HIV-infected persons, 2027 patients who started HAART during prospective follow-up were examined. Results were validated in another 2 groups of patients (n = 1946 and n = 1442). In total, 200 patients (9.9%) experienced clinical progression during 5177 person-years (incidence, 3.9/100 years). The most recently measured CD4 cell count, virus load, and hemoglobin level all were independently related to the risk of clinical progression, as was a diagnosis of severe AIDS before the start of HAART. On the basis of these findings, a scoring system was derived (range, 0-17). A single unit increase in the score was associated with a 38% increased risk of clinical progression (relative hazard, 1.38; 95% confidence interval, 1.33-1.43; P < .0001). The scoring system was validated with remarkably good agreement in the 2 other cohorts. This system can be used in patient and resource management.
A Clinically Prognostic Scoring System for Patients Receiving Highly Active Antiretroviral Therapy: Results from the EuroSIDA Study / J.D. Lundgren, A. Mocroft, J.M. Gatell, B. Ledergerber, A. D'Arminio Monforte, P. Hermans, F.D. Goebel, A. Blaxhult, O. Kirk, A.N. Phillips. - In: THE JOURNAL OF INFECTIOUS DISEASES. - ISSN 0022-1899. - 185:2(2002 Jan 15), pp. 178-187. (Intervento presentato al 40. convegno Interscience Conference on Antimicrobial Agents and Chemotherapy tenutosi a Toronto nel 2000) [10.1086/338267].
A Clinically Prognostic Scoring System for Patients Receiving Highly Active Antiretroviral Therapy: Results from the EuroSIDA Study
A. D'Arminio Monforte;
2002
Abstract
The risk of clinical progression for human immunodeficiency virus (HIV)-infected persons receiving treatment with highly active antiretroviral therapy (HAART) is poorly defined. From an inception cohort of 8457 HIV-infected persons, 2027 patients who started HAART during prospective follow-up were examined. Results were validated in another 2 groups of patients (n = 1946 and n = 1442). In total, 200 patients (9.9%) experienced clinical progression during 5177 person-years (incidence, 3.9/100 years). The most recently measured CD4 cell count, virus load, and hemoglobin level all were independently related to the risk of clinical progression, as was a diagnosis of severe AIDS before the start of HAART. On the basis of these findings, a scoring system was derived (range, 0-17). A single unit increase in the score was associated with a 38% increased risk of clinical progression (relative hazard, 1.38; 95% confidence interval, 1.33-1.43; P < .0001). The scoring system was validated with remarkably good agreement in the 2 other cohorts. This system can be used in patient and resource management.File | Dimensione | Formato | |
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