Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres
Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres
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DOI：
10.1097/00002030-199712000-00003
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发表时间：
1997-10-01
期刊：
影响因子：
3.8
通讯作者：
Portier, H
中科院分区：
文献类型：
--
作者：
Mouton, Y;Alfandari, S;Portier, H
目的：评估使用蛋白酶抑制剂治疗HIV感染的临床和经济后果。设计：多中心、观察性、回顾性队列研究。设置：法国10个艾滋病参考中心。患者：1995年9月至1996年10月在每个中心随访的所有患者。主要结果指标：艾滋病定义事件、死亡、卫生保健资源使用、抗逆转录病毒治疗管理。结果：来自10个中心的7749名患者的数据显示，住院天数减少了35%，新的艾滋病病例减少了35%，死亡人数减少了46%。在同一时期，接受抗逆转录病毒治疗的患者比例从36%上升到53%，其中包括从0.3%上升到18%的高效抗逆转录病毒治疗。总费用评估显示，每个病人每月治疗费用略有增加，为12美元。最早使用HAART的三个中心与最新使用HAART的三个中心的比较显示，早期HAART的明显益处是住院天数减少了41%，新的艾滋病病例减少了41%，死亡人数减少了69%。高效抗逆转录病毒疗法患者比例上升至27%，每月医疗保健费用减少248 852美元（即，每个病人每月101美元）。延迟开药中心的效果不太明显，住院天数减少了22%，新的艾滋病病例减少了31%，死亡人数减少了32.5%。高效抗逆转录病毒疗法患者比例上升至12%，每月保健费用增加113 578美元（即，结论：本研究支持HAART在HIV感染患者中的广泛使用。
Objective: To assess the clinical and economic consequences of the use of protease inhibitors in the treatment of HIV infection.Design: Multicentric, observational, retrospective cohort study.Setting: Ten AIDS reference centres in France.Patients: All patients followed in each centre from September 1995 through October 1996.Main outcome measures: AIDS-defining events, death, health-care resources use, administration of antiretroviral therapy.Results: Data from 7749 patients in 10 centres showed a drop in hospitalization days by 35%, new AIDS cases by 35%, and deaths by 46%. In the same period, the proportion of patients receiving antiretrovirals rose from 36 to 53% including highly active antiretroviral therapy (HAART), which rose from 0.3 to 18%. Overall cost evaluation showed a slight increase of monthly treatment cost of US$ 12 per patient. Comparison of the three centres that used HAART earliest to the three centres that used it latest showed a clear benefit to early HAART with a drop in hospitalization days by 41%, new AIDS cases by 41% and deaths by 69%. The proportion of patients with HAART rose to 27% and monthly health-care cost decreased by US$ 248 852 (i.e., by US$ 101 per patient per month). Late prescribing centres experienced a less marked effect with a drop in hospitalization days by 22%, new AIDS cases by 31%, and deaths by 32.5%. Proportion of patients with HAART rose to 12% and monthly health-care costs increased by US$ 113 578 (i.e., by US$ 38 per patient per month).Conclusions: This study supports the extensive use of HAART in HIV-infected patients.