Fatal and nonfatal AIDS and non-AIDS events in HIV-1-positive individuals with high CD4 cell counts according to viral load strata

TY - JOUR

T1 - Fatal and nonfatal AIDS and non-AIDS events in HIV-1-positive individuals with high CD4 cell counts according to viral load strata

AU - Reekie, Joanne

AU - Gatell, Jose M

AU - Yust, Israel

AU - Bakowska, Elzbieta

AU - Rakhmanova, Aza

AU - Losso, Marcelo

AU - Krasnov, Maksym

AU - Francioli, Patrick

AU - Kowalska, Justyna D

AU - Mocroft, Amanda

AU - EuroSIDA in EuroCoord

N1 - 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

PY - 2011/11/28

Y1 - 2011/11/28

N2 - Background: This study compared the incidence of fatal and nonfatal AIDS and non-AIDS events in HIV-positive individuals with a CD4 cell count more than 350cells/μl among viral load strata: low (<500copies/ml), intermediate (500-9999.9copies/ml) and high (10000copies/ml). Methods: Individuals contributed person-years at risk if their most recent CD4 cell count was more than 350cells/μl. Follow-up was censored if their CD4 cell count dropped below 350cells/μl. Poisson regression analysis investigated the relationship between viraemia and the incidence of AIDS and non-AIDS events. Results: Three hundred and fifty-four AIDS events occurred during 51732person-years of follow-up (PYFU), crude incidence rate of AIDS across the three strata was 0.53, 0.90 and 2.12 per 100PYFU, respectively. After adjustment, a higher rate of AIDS was observed in individuals with moderate [incidence rate ratio (IRR) 1.44, 1.02-2.05, P=0.03] and high viraemia had a higher rate (IRR 3.91, 2.89-5.89, P<0.0001) compared with low viraemia. Five hundred and seventy-two non-AIDS events occurred during 43784PYFU, the crude incidence rates were 1.28, 1.52, and 1.38 per 100PYFU, respectively. After adjustment, particularly for age, region of Europe and starting combination antiretroviral therapy, there was a 61% (IRR 1.61, 1.21-2.14, P=0.001) and 66% (IRR 1.66, 1.17-2.32, P=0.004) higher rate of non-AIDS in individuals with intermediate and high viraemia compared with low viraemia. Conclusion: In individuals with a CD4 + cell count more than 350cells/μl, an increased incidence of AIDS and a slightly increased incidence of non-AIDS was found in those with uncontrolled viral replication. The association with AIDS was clear and consistent. However, the association with non-AIDS was only apparent after adjustment and no differences were observed between intermediate and high viraemia.

AB - Background: This study compared the incidence of fatal and nonfatal AIDS and non-AIDS events in HIV-positive individuals with a CD4 cell count more than 350cells/μl among viral load strata: low (<500copies/ml), intermediate (500-9999.9copies/ml) and high (10000copies/ml). Methods: Individuals contributed person-years at risk if their most recent CD4 cell count was more than 350cells/μl. Follow-up was censored if their CD4 cell count dropped below 350cells/μl. Poisson regression analysis investigated the relationship between viraemia and the incidence of AIDS and non-AIDS events. Results: Three hundred and fifty-four AIDS events occurred during 51732person-years of follow-up (PYFU), crude incidence rate of AIDS across the three strata was 0.53, 0.90 and 2.12 per 100PYFU, respectively. After adjustment, a higher rate of AIDS was observed in individuals with moderate [incidence rate ratio (IRR) 1.44, 1.02-2.05, P=0.03] and high viraemia had a higher rate (IRR 3.91, 2.89-5.89, P<0.0001) compared with low viraemia. Five hundred and seventy-two non-AIDS events occurred during 43784PYFU, the crude incidence rates were 1.28, 1.52, and 1.38 per 100PYFU, respectively. After adjustment, particularly for age, region of Europe and starting combination antiretroviral therapy, there was a 61% (IRR 1.61, 1.21-2.14, P=0.001) and 66% (IRR 1.66, 1.17-2.32, P=0.004) higher rate of non-AIDS in individuals with intermediate and high viraemia compared with low viraemia. Conclusion: In individuals with a CD4 + cell count more than 350cells/μl, an increased incidence of AIDS and a slightly increased incidence of non-AIDS was found in those with uncontrolled viral replication. The association with AIDS was clear and consistent. However, the association with non-AIDS was only apparent after adjustment and no differences were observed between intermediate and high viraemia.

KW - AIDS-Related Opportunistic Infections

KW - Acquired Immunodeficiency Syndrome

KW - Adult

KW - Argentina

KW - CD4 Lymphocyte Count

KW - Disease Progression

KW - Europe

KW - Female

KW - Follow-Up Studies

KW - HIV Infections

KW - HIV-1

KW - Humans

KW - Incidence

KW - Israel

KW - Male

KW - Prospective Studies

KW - Risk Factors

KW - Viral Load

KW - Viremia

U2 - 10.1097/qad.0b013e32834cdb4b

DO - 10.1097/qad.0b013e32834cdb4b

M3 - Journal article

C2 - 21918422

SN - 1350-2840

VL - 25

SP - 2259

EP - 2268

JO - AIDS, Supplement

JF - AIDS, Supplement

IS - 18

ER -