Risk for opportunistic disease and death after reinitiating continuous antiretroviral therapy in patients with HIV previously receiving episodic therapy - a randomized trial
Risk for opportunistic disease and death after reinitiating continuous antiretroviral therapy in patients with HIV previously receiving episodic therapy - a randomized trial
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DOI：
10.7326/0003-4819-149-5-200809020-00003
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发表时间：
2008-09-02
影响因子：
39.2
通讯作者：
Neaton, J. D.
中科院分区：
文献类型：
--
作者：
El-Sadr, W. M.;Grund, B.;Neaton, J. D.
Background: Episodic use of antiretroviral therapy guided by CD4(+) cell counts is inferior to continuous antiretroviral therapy.Objective: To determine whether reinitiating continuous antiretroviral therapy in patients who received episodic treatment reduces excess risk for opportunistic disease or death.Design: Randomized, controlled trial.Patients: 5472 HIV-infected individuals with CD4(+) cell counts greater than 0.350 x 10(9) cells/L enrolled from January 2002 to January 2006.Intervention: Episodic or continuous antiretroviral therapy initially, followed by continuous therapy in participants previously assigned to episodic treatment.Results: Eighteen months after the recommendation to reinitiate continuous therapy, mean CD4(+) cell counts were 0.152 x 10(9) cells/L (95% CI, 0.136 to 0.167 x 10(9) cells/ L) less in participants previously assigned to episodic treatment (P < 0.001). The proportion of follow-up time spent with CD4(+) cell counts of 0.500 x 10(9) cells/L or more and HIV RNA levels of 400 copies/mL or less was 29% for participants initially assigned to episodic therapy and 66% for those assigned to continuous therapy. Participants who reinitiated continuous therapy experienced rapid suppression of HIV RNA levels (89.7% with HIV RNA levels
