Effectiveness of potent antiretroviral therapies on the incidence of opportunistic infections before and after AIDS diagnosis
Effectiveness of potent antiretroviral therapies on the incidence of opportunistic infections before and after AIDS diagnosis
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DOI：
10.1097/00002030-200102160-00008
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发表时间：
2001-02-16
期刊：
影响因子：
3.8
通讯作者：
Muñoz, A
中科院分区：
文献类型：
--
作者：
Detels, R;Tarwater, P;Muñoz, A
目的：确定强效抗逆转录病毒治疗在减少机会性感染（OI）方面的有效性，机会性感染既是一种表现事件，也是一种艾滋病定义事件。设计和方法：在1984-1989年，1990-1992年，结果：1993-1995年和1996-1998年，艾滋病血清转换者共发生OI 132例，艾滋病患者共发生OI 717例。与单药治疗相比，在有效的抗逆转录病毒治疗可用的日历期内，OI作为AIDS事件的相对危险度（RH）下降了81%。观察到鸟分枝杆菌复合体、巨细胞病毒病和食管念珠菌病的下降，但仅卡氏肺孢子虫肺炎有统计学意义。与单药治疗期相比，上一个日历期OI作为继发性感染的RH下降了77%。观察到所有四种OI均显著下降。预防性药物的使用并没有增加的时代，有效的抗逆转录病毒therapeutic.Conclusion：的风险OI的时代，有效的抗逆转录病毒疗法相比，单一疗法的时代已经显着下降，尽管同时减少预防性药物的使用。医生应考虑是否有必要将预防药物作为接受强效抗逆转录病毒治疗的患者的复杂药物方案的一部分。(C)2001年利平科特威廉姆斯&威尔金斯。
Objectives: To determine the effectiveness of potent antiretroviral therapy in reducing opportunistic infections (OI) as both a presenting event and subsequent to an AIDS-defining event.Design and methods: A total of 543 seroconverters and 1470 men with AIDS were compared for the time to development of OI as the presenting AIDS event and as a subsequent event in the 1984-1989, 1990-1992, 1993-1995, and 1996-1998 periods, when the major treatments were no therapy, monotherapy, combination therapy, and potent antiretroviral therapy, respectively.Results: The seroconverters suffered 132 OI and the participants with AIDS had 717 OI. The relative hazard (RH) of OI as the presenting AIDS event declined by 81% in the calendar period when potent antiretroviral therapy was available compared with the monotherapy period. Declines were observed for Mycobacterium avium complex, cytomegalovirus disease, and esophageal candidiasis, but were statistically significant only for Pneumocystis carinii pneumonia. The RH of OI as a secondary infection dropped by 77% in the last calendar period compared with the monotherapy period. A significant decline was observed for all four OI. Prophylactic drug use did not increase in the era of potent anti retroviral therapy.Conclusion: The hazard of OI in the era of potent antiretroviral therapy has declined dramatically compared with the era of monotherapy, despite the concurrent decrease in the use of prophylactic drugs. Physicians should consider whether it is necessary to include prophylactic drugs as part of the complex drug regimen for patients on potent antiretroviral therapy. (C) 2001 Lippincott Williams & Wilkins.