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HIV treatment outcomes after 10 years on ART in the TREAT Asia Observational Database (TAHOD) and Australian HIV Observational Database (AHOD).
Jiamsakul, Awachana; Rupasinghe, Dhanushi; Woolley, Ian; Choi, Jun Yong; Templeton, David J; Widhani, Alvina; Petoumenos, Kathy; Tanuma, Junko.
Afiliación
  • Jiamsakul A; The Kirby Institute, UNSW Sydney, NSW, Australia.
  • Rupasinghe D; The Kirby Institute, UNSW Sydney, NSW, Australia.
  • Woolley I; Monash Infectious Diseases, Monash Health, and Monash University, Clayton, Victoria, Australia.
  • Choi JY; Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
  • Templeton DJ; The Kirby Institute, UNSW Sydney, NSW, Australia.
  • Widhani A; Department of Sexual Health Medicine, Sydney Local Health District, Sydney, NSW, Australia and Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
  • Petoumenos K; Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
  • Tanuma J; The Kirby Institute, UNSW Sydney, NSW, Australia.
J Acquir Immune Defic Syndr ; 2024 Aug 22.
Article en En | MEDLINE | ID: mdl-39169454
ABSTRACT

BACKGROUND:

Increasing numbers of people with HIV have received prolonged antiretroviral therapy (ART). We assessed long-term immunological and survival outcomes among people with HIV from Asia (TAHOD) and Australia (AHOD).

METHODS:

People with HIV receiving ART for ≥10 years were included. Factors associated with CD4 counts in years 11-15 of ART were analysed using repeated measure linear regression. Survival after 10 years was analysed using competing risk regression.

RESULTS:

There were 7139 people included 4867 (68%) from TAHOD and 2272 (32%) from AHOD. Higher CD4 after 10 years were observed if the nadir CD4 in the first decade was higher (CD4 (cells/µL) 101-200 difference=35, 95%CI 18, 51; >200 difference=125, 95%CI 107, 142) compared to ≤50. The same patterns were observed in those who achieved CD4 ≥500 cells/µL which subsequently decreased to <500 (difference=225, 95%CI 213, 236); or those who achieved and maintained CD4 ≥500 cells/µL (difference=402, 95%CI 384, 420), compared to always <500 in the previous decade. Prior protease inhibitor (PI) -based regimen (difference=-17, 95%CI -33, -1) compared to no PI, and previous treatment interruptions (TI) of 14 days to 3 months and >6 months were associated with lower CD4 counts after 10 years (difference = -38, 95%CI -62, -15; and difference=-44, 95%CI -61, -27, respectively) compared to no TI. The mortality rate was 1.04 per 100 person-years. Virological failure was associated with subsequent mortality (sub-hazard ratio=1.34, 95%CI 1.04, 1.71).

CONCLUSIONS:

Sustaining high CD4 levels and minimising TI has far-reaching benefits well beyond the first decade of ART.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Acquir Immune Defic Syndr Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Acquir Immune Defic Syndr Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos