Laboratory and Clinical Predictors of Disease Progression following Initiation of Combination Therapy in HIV-Infected Adults in Thailand
- Publication Date
- August 15, 2012
- Journal
- PLOS ONE
- Authors
- Trinh Duong, Gonzague Jourdain, Nicole Ngo Giang Huong, Sophie Le Cœur, et al
- Volume
- 7
- Issue
- 8
- Pages
- e43375
- DOI
- https://dx.plos.org/10.1371/journal.pone.0043375
- Publisher URL
- http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0043375
- PubMed
- http://www.ncbi.nlm.nih.gov/pubmed/22905264
- PubMed Central
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419679
- Europe PMC
- http://europepmc.org/abstract/MED/22905264
- Web of Science
- 000307823600074
- Scopus
- 84865054223
- Mendeley
- http://www.mendeley.com/research/laboratory-clinical-predictors-disease-progression-following-initiation-combination-therapy-hivinfec
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Mendeley | Further Information
{"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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Relative Metric
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