Laboratory and Clinical Predictors of Disease Progression following Initiation of Combination Therapy in HIV-Infected Adults in Thailand
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{"title"=>"Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand", "type"=>"journal", "authors"=>[{"first_name"=>"Trinh", "last_name"=>"Duong", "scopus_author_id"=>"7102106091"}, {"first_name"=>"Gonzague", "last_name"=>"Jourdain", "scopus_author_id"=>"26642977900"}, {"first_name"=>"Nicole", "last_name"=>"Ngo-Giang-Huong", "scopus_author_id"=>"6602219633"}, {"first_name"=>"Sophie", "last_name"=>"Le Cœur", "scopus_author_id"=>"6603392912"}, {"first_name"=>"Pacharee", "last_name"=>"Kantipong", "scopus_author_id"=>"6603580797"}, {"first_name"=>"Sudanee", "last_name"=>"Buranabanjasatean", "scopus_author_id"=>"55324535000"}, {"first_name"=>"Prattana", "last_name"=>"Leenasirimakul", "scopus_author_id"=>"6506346370"}, {"first_name"=>"Sriprapar", "last_name"=>"Ariyadej", "scopus_author_id"=>"6507693445"}, {"first_name"=>"Somboon", "last_name"=>"Tansuphasawasdikul", "scopus_author_id"=>"14052998700"}, {"first_name"=>"Suchart", "last_name"=>"Thongpaen", "scopus_author_id"=>"6504821288"}, {"first_name"=>"Marc", "last_name"=>"Lallemant", "scopus_author_id"=>"24387959100"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84865054223", "doi"=>"10.1371/journal.pone.0043375", "sgr"=>"84865054223", "pmid"=>"22905264", "issn"=>"19326203", "pui"=>"365445625"}, "id"=>"c6f2372d-be09-310e-84d3-e4c94b08ab02", "abstract"=>"BACKGROUND: Data on determinants of long-term disease progression in HIV-infected patients on antiretroviral therapy (ART) are limited in low and middle-income settings.\\n\\nMETHODS: Effects of current CD4 count, viral load and haemoglobin and diagnosis of AIDS-defining events (ADEs) after start of combination ART (cART) on death and new ADEs were assessed using Poisson regression, in patient aged ≥ 18 years within a multi-centre cohort in Thailand.\\n\\nRESULTS: Among 1,572 patients, median follow-up from cART initiation was 4.4 (IQR 3.6-6.3) years. The analysis of death was based on 60 events during 6,573 person-years; 30/50 (60%) deaths with underlying cause ascertained were attributable to infections. Analysis of new ADE included 192 events during 5,865 person-years; TB and Pneumocystis jiroveci pneumonia were the most commonly presented first new ADE (35% and 20% of cases, respectively). In multivariable analyses, low current CD4 count after starting cART was the strongest predictor of death and of new ADE. Even at CD4 above 200 cells/mm(3), survival improved steadily with CD4, with mortality rare at ≥ 500 cells/mm(3) (rate 1.1 per 1,000 person-years). Haemoglobin had a strong independent effect, while viral load was weakly predictive with poorer prognosis only observed at ≥ 100,000 copies/ml. Mortality risk increased following diagnosis of ADEs during cART. The decline in mortality rate with duration on cART (from 21.3 per 1,000 person-years within first 6 months to 4.7 per 1,000 person-years at ≥ 36 months) was accounted for by current CD4 count.\\n\\nCONCLUSIONS: Patients with low CD4 count or haemoglobin require more intensive diagnostic and treatment of underlying causes. Maintaining CD4 ≥ 500 cells/mm(3) minimizes mortality. However, patient monitoring could potentially be relaxed at high CD4 count if resources are limited. Optimal ART monitoring strategies in low-income settings remain a research priority. Better understanding of the aetiology of anaemia in patients on ART could guide prevention and treatment.", "link"=>"http://www.mendeley.com/research/laboratory-clinical-predictors-disease-progression-following-initiation-combination-therapy-hivinfec", "reader_count"=>15, "reader_count_by_academic_status"=>{"Researcher"=>7, "Student > Postgraduate"=>2, "Student > Master"=>3, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Researcher"=>7, "Student > Postgraduate"=>2, "Student > Master"=>3, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Medicine and Dentistry"=>10, "Arts and Humanities"=>1, "Business, Management and Accounting"=>1, "Social Sciences"=>1, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Social Sciences"=>{"Social Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/591587"], "description"=>"<p>Based measurements within the last 9 months before date of death. Number of cases by cause of death: 10 TB, 20 other infections, 20 not related to infection and 10 not known.</p>", "links"=>[], "tags"=>["cd4", "viral", "haemoglobin"], "article_id"=>262075, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.g002", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Distribution_of_most_recent_CD4_count_A_viral_load_B_and_haemoglobin_C_measurement_at_time_of_death_by_cause_of_death_/262075", "title"=>"Distribution of most recent CD4 count (A), viral load (B) and haemoglobin (C) measurement at time of death, by cause of death.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 00:49:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/591692"], "description"=>"<p>cART, combination antiretroviral therapy; ADE, AIDS-defining event; py, person-years; CI, confidence interval.</p>a<p>Effects were estimated adjusted for <i>a priori</i> confounders, time since cART initiation, and current CD4 count, viral load and haemoglobin. Current CD4 count and haemoglobin, and CD4 count, viral load and haemoglobin at cART initiation were analysed as continuous variables.</p>b<p>To present the estimated effect of CD4 count (fitted square root transformed) and current haemoglobin (fitted with additional cubic spline term), we derived from the fitted model the rate at the marker value at which 50% of person-years of follow-up falls above and below within each strata, and then calculated the corresponding rate ratios.</p>c<p>Based on patients without prior AIDS diagnosis before cART initiation. Only 1 patient was diagnosed with a severe ADE after starting cART, who had progressive multifocal leukoencephalopathy.</p>", "links"=>[], "tags"=>["factors", "initiation", "progression"], "article_id"=>262179, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.t003", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Predictive_effects_of_factors_after_cART_initiation_on_progression_to_death_and_to_new_ADE_/262179", "title"=>"Predictive effects of factors after cART initiation on progression to death and to new ADE.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 00:50:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/591738"], "description"=>"<p>cART, combination antiretroviral therapy; HBV, hepatitis B virus; HCV, hepatitis C virus; PMTCT, prevent of mother-to-child transmission; ADE, AIDS-defining event; NNRTI, non-nucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; IQR, inter-quartile range.</p>a<p>Percentage based on total with data available. Number with missing data: sex (1), HCV status (269), CD4 count (32), HIV-1 RNA (137), haemoglobin (59).</p>b<p>ADEs were defined as either mild or moderate/severe based on prognostic categories proposed by Mocroft et al <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0043375#pone.0043375-Mocroft2\" target=\"_blank\">[26]</a>. Note only 2 patients were previously diagnosed with a severe ADE.</p>c<p>The 46 patients starting with regimens containing NNRTI+PI were all previously on dual therapy.</p>", "links"=>[], "tags"=>["characteristics", "initiation"], "article_id"=>262225, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.t001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patients_8217_characteristics_at_cART_initiation_N_8202_8202_1572_/262225", "title"=>"Patients’ characteristics at cART initiation (N = 1572).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 00:50:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/591463"], "description"=>"<p>The closest measurement to each nominal time points within a±3 months window was selected for each patient.</p>", "links"=>[], "tags"=>["cd4", "viral", "haemoglobin", "initiation"], "article_id"=>261945, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.g001", "stats"=>{"downloads"=>2, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Distribution_of_CD4_count_A_viral_load_B_and_haemoglobin_C_over_time_from_initiation_of_cART_/261945", "title"=>"Distribution of CD4 count (A), viral load (B) and haemoglobin (C) over time from initiation of cART.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 00:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/591651"], "description"=>"<p>ADE, AIDS-defining event; cART, combination antiretroviral therapy.</p>a<p>69 of the 1572 patients included in analyses of progression to death developed a new ADE after cART initiation but before having at least 1 CD4 count and viral load evaluation while on treatment, and therefore were excluded in the analyses of progression to first new ADE.</p>b<p>153 patients progressed to ≥1 new ADE (s), while 39 patients died without having a new ADE after starting cART.</p>", "links"=>[], "tags"=>["events", "years", "follow-up", "contributing"], "article_id"=>262135, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.t002", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_patients_events_and_years_of_follow_up_contributing_to_analyses_/262135", "title"=>"Number of patients, events and years of follow-up contributing to analyses.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 00:49:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/591779"], "description"=>"<p>cART, combination antiretroviral therapy; ADE, AIDS-defining event; py, person-years; CI, confidence interval.</p>a<p>Effects were estimated adjusted for <i>a priori</i> confounders, time since cART initiation, and current CD4 count, viral load and haemoglobin.</p>", "links"=>[], "tags"=>["factors", "initiation", "progression", "adjusted", "cd4", "haemoglobin", "viral"], "article_id"=>262262, "categories"=>["Biotechnology", "Infectious Diseases"], "users"=>["Trinh Duong", "Gonzague Jourdain", "Nicole Ngo-Giang-Huong", "Sophie Le Coeur", "Pacharee Kantipong", "Sudanee Buranabanjasatean", "Prattana Leenasirimakul", "Sriprapar Ariyadej", "Somboon Tansuphasawasdikul", "Suchart Thongpaen", "Marc Lallemant"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0043375.t004", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Predictive_effects_of_factors_at_cART_initiation_on_progression_to_death_and_to_new_ADE_adjusted_for_current_CD4_count_haemoglobin_and_viral_load_/262262", "title"=>"Predictive effects of factors at cART initiation on progression to death and to new ADE, adjusted for current CD4 count, haemoglobin and viral load.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 00:50:35"}

PMC Usage Stats | Further Information

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Relative Metric

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