Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach
Publication Date
September 08, 2017
Authors
Mar Masiá, Sergio Padilla, Santiago Moreno, Xavier Barber, et al
Volume
12
Issue
9
Pages
e0184329
DOI
https://dx.plos.org/10.1371/journal.pone.0184329
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0184329
Scopus
85029487713
Mendeley
http://www.mendeley.com/research/prediction-longterm-outcomes-hivinfected-patients-developing-nonaids-events-using-multistate-approac-2
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"scopus_author_id"=>"36787906700"}, {"first_name"=>"Maria", "last_name"=>"Leyes", "scopus_author_id"=>"6603911624"}, {"first_name"=>"Ma Angels", "last_name"=>"Ribas", "scopus_author_id"=>"7003643347"}, {"first_name"=>"Antoni A.", "last_name"=>"Campins", "scopus_author_id"=>"56177060000"}, {"first_name"=>"Carmen", "last_name"=>"Vidal", "scopus_author_id"=>"55430198100"}, {"first_name"=>"Leire", "last_name"=>"Gil", "scopus_author_id"=>"57188769842"}, {"first_name"=>"Francisco", "last_name"=>"Fanjul", "scopus_author_id"=>"6508284230"}, {"first_name"=>"Carmen", "last_name"=>"Marinescu", "scopus_author_id"=>"35170483100"}, {"first_name"=>"Esteban", "last_name"=>"Ribera", "scopus_author_id"=>"7005262513"}, {"first_name"=>"Jesús", "last_name"=>"Santos", "scopus_author_id"=>"35465595800"}, {"first_name"=>"Manuel", "last_name"=>"Márquez", "scopus_author_id"=>"7103125444"}, {"first_name"=>"Isabel", "last_name"=>"Viciana", "scopus_author_id"=>"8943468800"}, {"first_name"=>"Rosario", "last_name"=>"Palacios", "scopus_author_id"=>"7101602298"}, {"first_name"=>"Isabel", "last_name"=>"Pérez", "scopus_author_id"=>"8117318300"}, {"first_name"=>"Carmen Maria", "last_name"=>"González", "scopus_author_id"=>"57188770149"}, {"first_name"=>"Pompeyo", "last_name"=>"Viciana", "scopus_author_id"=>"7003726390"}, {"first_name"=>"Manuel", "last_name"=>"Leal", "scopus_author_id"=>"18040415300"}, {"first_name"=>"Luis Fernando", "last_name"=>"López-Cortés", "scopus_author_id"=>"7003955115"}, {"first_name"=>"Mónica", "last_name"=>"Trastoy", "scopus_author_id"=>"23010502700"}, {"first_name"=>"Nuria", "last_name"=>"Espinosa", "scopus_author_id"=>"12647528300"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"85029487713", "pmid"=>"28886092", "pui"=>"618237772", "isbn"=>"1932-6203", "scopus"=>"2-s2.0-85029487713", "doi"=>"10.1371/journal.pone.0184329", "issn"=>"19326203"}, "id"=>"4ebd36e1-9e6e-3fb6-9a96-4b8e67d84ca7", "abstract"=>"OBJETIVES Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. DESIGN Prospective multicenter cohort study. METHODS Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced (\"NAE development\"); from alive and NAE-experienced to death (\"Death after NAE\"); and from alive and NAE-free to death (\"Death without NAE\"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition \"Death after NAE\". RESULTS 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition \"Death after NAE\" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), age>50 years (1.78, 1.08-2.94), hepatitis C-coinfection (2.52, 1.38-4.61), lower CD4 cell count at cohort entry (HR 2.49; 95%CI 1.20-5.14 for CD4 cell count below 200 and HR 2.16; 95%CI 1.01-4.66 for CD4 cell count between 200-350, both compared to CD4 cell count higher than 500) and concomitant CD4<200 cells/mL (2.22, 1.42-3.44) were associated with death after NAE. CD4 count and HIV-1 RNA at engagement, previous AIDS and hepatitis C-coinfection predicted mortality in NAE-free persons. CONCLUSION NAEs, including low-severity events, increase prominently the risk for mortality in PLWH. Prognostic factors differ between NAE-experienced and NAE-free persons. These findings should be taken into account in the clinical management of PLWH developing NAEs and may permit more targeted prevention efforts.", "link"=>"http://www.mendeley.com/research/prediction-longterm-outcomes-hivinfected-patients-developing-nonaids-events-using-multistate-approac-2", "reader_count"=>9, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>2, "Student > Master"=>1, "Other"=>1, "Unspecified"=>1, "Student > Ph. D. Student"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>2, "Student > Master"=>1, "Other"=>1, "Unspecified"=>1, "Student > Ph. D. Student"=>1}, "reader_count_by_subject_area"=>{"Mathematics"=>2, "Medicine and Dentistry"=>4, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Nursing and Health Professions"=>1, "Unspecified"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Mathematics"=>{"Mathematics"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "group_count"=>1}

Scopus | Further Information

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