Journal Article

Long-Term Outcome and Treatment Modifications in a Prospective Cohort of Human Immunodeficiency Virus Type 1-Infected Patients on Triple-Drug Antiretroviral Regimens

Pierre-Marie Girard, Marguerite Guiguet, Diane Bollens, Isabelle Goderel, Marie-Caroline Meyohas, Isabelle Lecomte, Gilles Raguin, Jacques Frottier, Willy Rozenbaum and Patrice Jaillon

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 4, pages 987-994
Published in print October 2000 | ISSN: 1058-4838
Published online October 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318154
Long-Term Outcome and Treatment Modifications in a Prospective Cohort of Human Immunodeficiency Virus Type 1-Infected Patients on Triple-Drug Antiretroviral Regimens

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We designed a cohort in order to assess the long-term effects of triple-drug antiretroviral combinations in 608 patients infected with human immunodeficiency virus type 1 (HIV-1). We recruited patients who had been previously treated with nucleoside analogues as well as treatment-naive patients who were starting triple-drug antiretroviral combinations consisting of nucleoside analogues, either alone or in combination with a protease inhibitor. After a median follow-up time of 22 months, the incidence rates of acquired immune deficiency syndrome–defining events and death were, respectively, 6.9 (95% confidence interval [CI], 5.3–8.8) and 2.9 (95% CI, 1.9–4.2) per 100 person-years. Advanced clinical stage of disease (P = .004), a low CD4+ cell count (P = .002), and a low quality-of-life score (P = .001) at baseline were independent predictors of clinical progression. The initial triple-drug combination was modified a total of 647 times in 321 patients. The only independent predictor of treatment modification was previous exposure to a nucleoside analogue in patients who did not receive a new nucleoside analogue at inclusion (P = .001). Plasma HIV RNA values below 500 copies/mL were obtained in 88% of the treatment-naive patients and in 57% of the previously treated patients (P < .001). compared with previously treated patients who received ⩾1 new nucleoside analogue at enrollment, previously treated patients who did not receive a new nucleoside analogue at enrollment were twice as likely to have plasma HIV RNA values >500 copies/mL at the last visit (adjusted odds ratio [OR], 1.8; 95% confidence interval [CI], 1.2–2.8), and the antiretroviral-naive patients were significantly less likely to have plasma HIV RNA values >500 copies/mL at the last visit (adjusted OR, 0.2; 95% CI, 0.1–0.4).

Journal Article.  4606 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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