| AIDS-defining opportunistic illnesses in US patients, 1994-2007: a cohort study. | |
MedLine Citation:
|
PMID: 20502317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To assess the incidence and spectrum of AIDS-defining opportunistic illnesses in the highly active antiretroviral therapy (cART) era. DESIGN: A prospective cohort study of 8070 participants in the HIV Outpatient Study at 12 U.S. HIV clinics. METHODS: We calculated incidence rates per 1000 person-years of observation for the first opportunistic infection, first opportunistic malignancy, and first occurrence of each individual opportunistic illness during 1994-2007. Using stratified Poisson regression models, and adjusting for sex, race, and HIV risk category, we modeled annual percentage changes in opportunistic illness incidence rates by calendar period. RESULTS: Eight thousand and seventy patients (baseline median age 38 years; median CD4 cell count 298 cells/microl) experienced 2027 incident opportunistic illnesses during a median of 2.9 years of observation. During 1994-1997, 1998-2002, and 2003-2007, respectively, rates of opportunistic infections (per 1000 person-years) were 89.0, 25.2 and 13.3 and rates of opportunistic malignancies were 23.4, 5.8 and 3.0 (P for trend <0.001 for both). Opportunistic illness rate decreases were similar for the subset of patients receiving cART. During 2003-2007, there were no significant changes in annual rates of opportunistic infections or opportunistic malignancies; the leading opportunistic illnesses (rate per 1000 person-years) were esophageal candidiasis (5.2), Pneumocystis pneumonia (3.9), cervical cancer (3.5), Mycobacterium avium complex infection (2.5), and cytomegalovirus disease (1.8); 36% opportunistic illness events occurred at CD4 cell counts at least 200 cells/microl. CONCLUSIONS: Opportunistic illness rates declined precipitously after introduction of cART and stabilized at low levels during 2003-2007. In this contemporary cART era, a third of opportunistic illnesses were diagnosed at CD4 cell counts at least 200 cells/microl. |
Authors:
|
Kate Buchacz; Rose K Baker; Frank J Palella; Joan S Chmiel; Kenneth A Lichtenstein; Richard M Novak; Kathleen C Wood; John T Brooks; |
Related Documents
:
|
18601727 - Utility of cd4 cell counts for early prediction of virological failure during antiretro... 9039547 - Prophylaxis against mycobacterium avium-intracellulare complex infections in human immu... 19478647 - Treatment of spondylodiscitis in human immunodeficiency virus-infected patients: a comp... 18157397 - Prevalence of intestinal microsporidiosis in human immunodeficiency virus-infected pati... 14678637 - Visceral leishmaniasis in those infected with hiv: clinical aspects and other opportuni... 10623727 - Genetic heterogeneity of hypervariable region 1 of the hepatitis c virus (hcv) genome a... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: AIDS (London, England) Volume: 24 ISSN: 1473-5571 ISO Abbreviation: AIDS Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-06-11 Completed Date: 2011-01-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8710219 Medline TA: AIDS Country: England |
Other Details:
|
Languages: eng Pagination: 1549-59 Citation Subset: IM; X |
Affiliation:
|
Divisions of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. acu7@cdc.gov |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
AIDS-Related Opportunistic Infections
/
epidemiology*,
immunology Acquired Immunodeficiency Syndrome / drug therapy, epidemiology*, immunology Adult Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Cohort Studies Humans Immunocompromised Host* / immunology Incidence Male Neoplasms / epidemiology*, immunology Probability Prospective Studies United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
|
200-2001-00133//PHS HHS; 200-2006-18797//PHS HHS |
| Investigator | |
Investigator/Affiliation:
|
John T Brooks / ; Kate Buchacz / ; Marcus Durham / ; Kathleen Wood / ; Rose K Baker / ; James T Richardson / ; Darlene Hankerson / ; Carl Armon / ; Frank J Palella / ; Joan S Chmiel / ; Carolyn Studney / ; Onyinye Enyia / ; Kenneth A Lichtenstein / ; Cheryl Stewart / ; John Hammer / ; Benjamin Young / ; Kenneth S Greenberg / ; Barbara Widick / ; Joslyn D Axinn / ; Bienvenido G Yangco / ; Kalliope Halkias / ; Douglas J Ward / ; Jay Miller / ; Jack Fuhrer / ; Linda Ording-Bauer / ; Rita Kelly / ; Jane Esteves / ; Ellen M Tedaldi / ; Ramona A Christian / ; Faye Ruley / ; Dania Beadle / ; Richard M Novak / ; Andrea Wendrow / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indica...
Next Document: Triplex-forming MicroRNAs form stable complexes with HIV-1 provirus and inhibit its replication.