Combination antiretroviral therapy and recent declines in AIDS incidence and mortality
Combination antiretroviral therapy and recent declines in AIDS incidence and mortality
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DOI：
10.1086/314623
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发表时间：
1999-03-01
影响因子：
6.4
通讯作者：
Buchbinder, SP
中科院分区：
文献类型：
--
作者：
Vittinghoff, E;Scheer, S;Buchbinder, SP
最近艾滋病发病率和死亡率下降的原因可能包括治疗方面的进步，但这些原因可能与早先人类免疫缺陷病毒(HIV)感染发病率的下降相混淆。为了确定艾滋病和死亡率的下降是否部分源于联合抗逆转录病毒疗法的广泛使用，对622名艾滋病毒阳性男子进行了跟踪调查，他们的血清转换日期具有很好的特征。在这一组中，联合疗法仅在1996年开始广泛使用。在COX比例风险模型中，1996年历期与艾滋病(相对危险度[RH]=0.19，95%可信区间[CI]，0.05-0.69，P=0.01)和死亡(RH=0.45，95%可信区间，0.21-0.95，P=0.04)的缓慢进展显著相关，HIV感染率的下降，HIV毒力的变化，以及终点的漏报不能完全解释1996年艾滋病和死亡率的下降，引入联合抗逆转录病毒治疗作为治疗标准可能已经产生了可测量的效果。
The reasons for recent declines in AIDS incidence and mortality may include advances in treatment, but these may be confounded by earlier declines in the incidence of human inmunodeficiency virus (HIV) infection. To determine whether the declines in AIDS and mortality may, in part, stem from wider use of combination antiretroviral therapy, 622 HIV-positive men with well-characterized dates of seroconversion were followed. In this group, combination therapy came into widespread use in only 1996. In a Cox proportional hazards model, the 1996 calendar period was significantly associated with slower progression to AIDS (relative hazard [RH] = 0.19, 95% confidence interval [CI], 0.05-0.69, P = .01) and death (RH = 0.45, 95% CI, 0.21-0.95, P = .04), Declines in incidence of HIV infection, changes in HIV virulence, and end-point underreporting cannot fully explain the decline in AIDS and death in 1996, The introduction of combination antiretroviral therapy as the standard of care may already have had measurable effects.