| Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy. | |
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MedLine Citation:
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PMID: 22112597 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Despite the known substantial benefits of combination antiretroviral therapy (cART), cumulative adverse effects could still limit the overall long-term treatment benefit. Therefore we investigated changes in the rate of death with increasing exposure to cART. METHODS:: 12069 patients were followed from baseline, which was defined as the time of starting cART or enrolment into EuroSIDA whichever occurred later, until death or six months after last follow-up visit. Incidence rates (IR) of death were calculated per 1000 person-years of follow-up (PYFU) and stratified by time of exposure to cART (≥3 antiretrovirals): <2, 2-3.99, 4-5.99, 6-7.99 and >8 years. Duration of cART exposure was the cumulative time actually receiving cART. Poisson regression models were fitted for each cause of death separately. RESULTS:: 1297 patients died during 70613 PYFU (IR 18.3 per 1000 PYFU, 95%CI: 17.4-19.4), 413 due to AIDS (5.85, 95%CI: 5.28-6.41) and 884 due to non-AIDS-related cause (12.5, 95%CI: 11.7-13.3). After adjustment for confounding variables, including baseline CD4 cell count and HIV RNA, there was a significant decrease in the rate of all-cause and AIDS-related death between 2-3.99 years and longer exposure time. In the first two years on cART the risk of non-AIDS death was significantly lower, but no significant difference in the rate of non-AIDS-related deaths between 2-3.99 years and longer exposure to cART was observed. CONCLUSIONS:: In conclusion, we found no evidence of an increased risk of both all-cause and non-AIDS related deaths with long-term cumulative cART exposure. |
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Authors:
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Justyna D Kowalska; Joanne Reekie; Amanda Mocroft; Peter Reiss; Bruno Ledergerber; Jose Gatell; Antonella d'Arminio Monforte; Andrew Phillips; Jens D Lundgren; Ole Kirk; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-22 |
Journal Detail:
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Title: AIDS (London, England) Volume: - ISSN: 1473-5571 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710219 Medline TA: AIDS Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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aCopenhagen HIV Programme, University of Copenhagen, Denmark bUniversity College London Medical School, Royal Free Campus, London, United Kingdom cAcademic Medical Center, Amsterdam, Netherlands dDivision of Infectious Diseases and Hospital Epidemiology, University Hospital, University of Zürich, Zürich, Switzerland eHospital Clinic, University of Barcelona, Barcelona, Spain fHospital San Paolo, University of Milan, Milan, Italy gDepartment of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. |
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