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When to Initiate Combined Antiretroviral Therapy to Reduce Mortality and AIDS-Defining Illness in HIV-Infected Persons in Developed CountriesAnnals of Internal Medicine, 154
- Publisher
- American Medical Association
- Copyright
- Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
- ISSN
- 2168-6106
- eISSN
- 2168-6114
- DOI
- 10.1001/archinternmed.2011.401
- pmid
- 21949165
- Publisher site
- See Article on Publisher Site
Abstract
ORIGINAL INVESTIGATION Timing of HAART Initiation and Clinical Outcomes in Human Immunodeficiency Virus Type 1 Seroconverters Writing Committee for the CASCADE Collaboration* Background: To estimate the clinical benefit of highly Results: Of 9455 patients with 52 268 person-years of active antiretroviral therapy (HAART) initiation vs de- follow-up, 812 (8.6%) developed AIDS and 544 (5.8%) ferral in a given month in patients with CD4 cell counts died. In CD4 cell count strata of 200 to 349, 350 to 499, less than 800/µL. and 500 to 799/µL, HAART initiation was associated with adjusted hazard ratios (95% CIs) for AIDS/death of 0.59 Methods: In this observational cohort study of human (0.43-0.81), 0.75 (0.49-1.14), and 1.10 (0.67-1.79), re- immunodeficiency virus type 1 seroconverters from spectively. In the analysis of all-cause mortality, HAART CASCADE (Concerted Action on SeroConversion to AIDS initiation was associated with adjusted hazard ratios (95% and Death in Europe), we constructed monthly sequen- CIs) of 0.71 (0.44-1.15), 0.51 (0.33-0.80), and 1.02 (0.49- tial nested subcohorts between January 1996 and May 2.12), respectively. Numbers needed to treat (95% CIs) 2009, including all eligible HAART-naive, AIDS-free in- to prevent 1 AIDS event or death within 3 years were 21 dividuals with a CD4
Journal
JAMA Internal Medicine – American Medical Association
Published: Sep 26, 2011