Document Detail


Clinical and immunologic progression in HIV-infected US women before and after the introduction of highly active antiretroviral therapy.
MedLine Citation:
PMID:  12902807     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine factors associated with clinical and immunologic HIV disease progression in a cohort of US women. DESIGN: Analysis of data from a prospective, longitudinal, case-control study of HIV-infected women followed every 6 months for 7 years. SETTING: Four urban clinical centers in the United States. PARTICIPANTS: 648 HIV-infected women who did not have AIDS at time of entry into the study. MEASUREMENTS: Structured clinical and behavioral interviews; protocol-directed physical examinations; CD4 lymphocyte counts; plasma HIV RNA; infectious pathogen serologies. RESULTS With 2304 women-years of follow-up, 46.1% of the women developed AIDS; however, 93.3% of the diagnoses were based on CD4 counts dropping to <200 cells/mm(3). Only 10.6% of the women with CD4 counts <200 cells/mm(3) developed an opportunistic infection. Baseline CD4 count was the strongest predictor of subsequent clinical progression. Illicit substance use, multiple pregnancies, demographic variables, and other infections were not associated with progression. Among women with CD4 counts >500 cells/mm(3) at baseline, those who were anemic or had hepatitis C were more likely to progress to AIDS. By the end of the study, only 52% of the participants were on highly active antiretroviral therapy (HAART). CONCLUSIONS: Despite underutilization of HAART in this multicenter cohort of urban women, opportunistic infections were uncommon, despite CD4 declines.
Authors:
Kenneth H Mayer; Joseph W Hogan; Dawn Smith; Robert S Klein; Paula Schuman; Joseph B Margolick; Christina Korkontzelou; Homayoon Farzedegan; David Vlahov; Charles C J Carpenter;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  33     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-06     Completed Date:  2003-09-16     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  614-24     Citation Subset:  IM; X    
Affiliation:
Miriam Hospital and dagger Brown University, Providence, Rhode Island 02906, USA. Kenneth_Mayer@brown.edu
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / epidemiology
Acquired Immunodeficiency Syndrome / diagnosis,  epidemiology
Adolescent
Adult
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count
Case-Control Studies
Cohort Studies
Disease Progression
Female
HIV Infections / diagnosis*,  immunology*,  therapy
Humans
Logistic Models
Middle Aged
Questionnaires
Risk Factors
United States / epidemiology
Urban Population

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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