Document Detail


Predictors of success with highly active antiretroviral therapy in an antiretroviral-naive urban population.
MedLine Citation:
PMID:  20156096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abstract Predictors of successful virologic, immunologic, and clinical response with combined antiretroviral therapy (cART) containing a boosted protease inhibitor or a nonnucleoside reverse transcriptase inhibitor were analyzed among an antiretroviral naive (ARV-naive) urban cohort. Measures of success included virologic suppression [HIV-1 viral load (VL) <400 copies/ml], an increase in CD4(+) T cells from baseline of >100 cells/microl, and lack of development of an AIDS-defining illness at 24 and 48 weeks after cART initiation. Two hundred and eighty-seven ARV-naive patients were included in this cohort, of which 76.7% were male and 86.8% were nonwhite. At the time of cART initiation their median age was 39 years, the geometric mean CD4(+) count was 42 cells/microl, and the mean viral load was 5.3 log(10) copies/ml. At 48 weeks, 72% of patients achieved virologic suppression, with > or =90% adherence and high school graduation predicting viral undetectability at 48 weeks. Baseline VL < or =100,000 copies/ml and a CD4(+) cell count >100 cells/microl were associated with viral suppression at 24 weeks [OR (95% CI) = 3.55 (1.29-9.81) and 3.96 (1.19-13.15), respectively]; female gender was associated with a greater increase in CD4(+) cell counts [OR (95% CI) = 7.41 (2.48-22.1)]. CDC stage A1-C2 at baseline predicted lack of clinical progression at 48 weeks. The results of this analysis of an ARV-naive cohort comprised predominantly of indigent, minority patients suggest that men who did not have a high school education and who had advanced HIV infection are less likely to have therapeutic success after cART initiation.
Authors:
Elisa Zaragoza-Macias; Dominique Cosco; Minh Ly Nguyen; Carlos Del Rio; Jeffrey Lennox
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  26     ISSN:  1931-8405     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-04-21     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Emory University School of Medicine , Atlanta, GA 30303, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active / methods*
CD4 Lymphocyte Count
Female
HIV Infections / drug therapy*,  immunology,  virology
HIV-1 / isolation & purification
Humans
Male
Middle Aged
Prognosis
Treatment Outcome
Urban Population
Viral Load
Grant Support
ID/Acronym/Agency:
2P30 AI 50409-04A1/AI/NIAID NIH HHS; D43 TW01042/TW/FIC NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents
Comments/Corrections

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