CD4+count and risk of non-AIDS diseases following initial treatment for HIV infection
CD4+count and risk of non-AIDS diseases following initial treatment for HIV infection
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DOI：
10.1097/qad.0b013e3282f7cb76
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发表时间：
2008-04-23
期刊：
影响因子：
3.8
通讯作者：
Neaton, James D.
中科院分区：
文献类型：
--
作者：
Baker, Jason V.;Peng, Grace;Neaton, James D.
背景：随着联合抗逆转录病毒治疗的出现，艾滋病相关发病率和死亡率的下降与HIV+患者中慢性非艾滋病终末器官疾病的相对增加相一致。目的：在1397名开始抗逆转录病毒治疗的患者中，检查最新的CD4+计数与非艾滋病疾病风险的相关性。方法：在中位数5年的随访中评估了CD4+计数和HIV RNA水平以及致命的和非致命的艾滋病和非艾滋病疾病(肝、心血管、肾脏和癌症)。结果：共有227名患者经历过艾滋病事件，80名患者发生了非艾滋病疾病事件。艾滋病和非艾滋病患病率(事件/百人年)分别下降，最新的CD_4+计数较高：13.8和2.1，最新CD_4+计数低于200个/亩L；2.0和1.7，计数200-350个/亩L；0.7和0.7，计数超过350个/亩L。在调整基线协变量和最新的HIV RNA水平后，艾滋病和非艾滋病疾病的风险降低了44%(危险比0.50-0.62的95%可信区间，P
Background: Reductions in AIDS-related morbidity and mortality following the advent of combination antiretroviral therapy have coincided with relative increases in chronic non-AIDS end-organ diseases among HIV+ patients.Objective: To examine the association of latest CD4+ counts with risk of non-AIDS diseases in a cohort of 1397 patients who initiate antiretroviral therapy.Methods: CD4+ counts and HIV RNA levels along with fatal, and non-fatal, AIDS and non-AIDS diseases (liver, cardiovascular, renal, and cancer) were assessed over a median follow-up of 5 years. Cox proportional regression models were used to study risk associations.Results: A total of 227 patients experienced an AIDS event and 80 patients developed a non-AIDS disease event. Both AIDS and non-AIDS diseases rates (events/100 person-years), respectively, declined with higher latest CD4+ counts: 13.8 and 2.1 with latest CD4+ counts less than 200cells/mu l; 2.0 and 1.7 for counts of 200-350 cells/mu l; and 0.7 and 0.7 for counts greater than 350cells/mu l. After adjusting for baseline covariates and the latest HIV RNA level, risk of AIDS and non-AIDS diseases were lowered by 44% (95% confidence interval for hazard ratio 0.50-0.62, P