Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study
Само за регистроване кориснике
2014
Аутори
Jevtović, ĐorđeDragović, Gordana
Salemović, Dubravka
Ranin, Jovan
Kusić, Jovana
Marinković, Jelena
Đurković-Đaković, Olgica
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Introduction: We evaluated the effects of highly-active-antiretroviral-therapy (HAART) in a resource-limited settings. Methods: A cross-sectional study was performed in patients who had initiated HAART at the HIV/AIDS-Center, Belgrade, Serbia. Treatment response was considered favorable in case of the achievement of undetectable HIVRNA plasma-viral-load (pVL lt 50 copies/mu L), and with the CD4+ T-cell counts increased above 350 cells/mu L. The treatment failure was defined as pVL over 1.7 log(10) copies/mL, regardless of immunological improvement. Results: Eight hundred and forty HIV infected patients were followed-up for 8.2 +/- 3.4 years. Out of 697 patients available for follow-up, 113 (16.2%) patients died, 44 (6.3%) experienced treatment failure, while 540 (77.5%) had sustained undetectable viremia. In 419 (60.1%) favorable treatment response was achieved, while the dissociation between immunological and virological responses to HAART occurred in 121 (14.4%). A baseline CD4+ T-...cell counts above 200 cells/mL was the single independent predictor of a favorable treatment response (HR = 2, 95%CI = 1.69-2.61, P = 0.001), while pre-treatment with ART, HCV co-infection and AIDS at the time of treatment initiation, were all factors preventing a favorable response (HR = 0.27, 95% CI = 0.19-0.36, P = 0.001; HR = 0.75, 95% CI = 0.56-0.95, P = 0.02; HR = 0.73, 95% CI = 0.17-0.95, P = 0.018, respectively). A sustained viral suppression was an independent predictor of survival (HR = 0.2, 95% CI 0.07-0.61, P = 0.004). HAART treated HIV-infected patients who reach and maintain undetectable viremia, have an 80% probability of a 14-years survival (P = 0.08, log-rank). Conclusion: If patient with advanced HIV-related immunodeficiency reach and maintain optimal viral suppression during HAART, regardless of the level of immune recovery, and if they continue to maintain this, their prognosis may be fairly good even in the resource-limited settings.
Кључне речи:
HIV / HAART / Survival / Resource limited settingsИзвор:
Biomedicine & Pharmacotherapy, 2014, 68, 3, 391-395Издавач:
- Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux
Финансирање / пројекти:
- Контрола инфекција апикомплексним патогенима: од нових места деловања лека до предикције (RS-MESTD-Integrated and Interdisciplinary Research (IIR or III)-41019)
- Филогенетски приступ анализи молекуларне еволуције високо варијабилних вируса - коинфекције, интеракција вируса и домаћина (RS-MESTD-Basic Research (BR or ON)-175024)
DOI: 10.1016/j.biopha.2014.01.001
ISSN: 0753-3322
PubMed: 24486106
WoS: 000335395400020
Scopus: 2-s2.0-84899485368
Институција/група
Institut za medicinska istraživanjaTY - JOUR AU - Jevtović, Đorđe AU - Dragović, Gordana AU - Salemović, Dubravka AU - Ranin, Jovan AU - Kusić, Jovana AU - Marinković, Jelena AU - Đurković-Đaković, Olgica PY - 2014 UR - http://rimi.imi.bg.ac.rs/handle/123456789/589 AB - Introduction: We evaluated the effects of highly-active-antiretroviral-therapy (HAART) in a resource-limited settings. Methods: A cross-sectional study was performed in patients who had initiated HAART at the HIV/AIDS-Center, Belgrade, Serbia. Treatment response was considered favorable in case of the achievement of undetectable HIVRNA plasma-viral-load (pVL lt 50 copies/mu L), and with the CD4+ T-cell counts increased above 350 cells/mu L. The treatment failure was defined as pVL over 1.7 log(10) copies/mL, regardless of immunological improvement. Results: Eight hundred and forty HIV infected patients were followed-up for 8.2 +/- 3.4 years. Out of 697 patients available for follow-up, 113 (16.2%) patients died, 44 (6.3%) experienced treatment failure, while 540 (77.5%) had sustained undetectable viremia. In 419 (60.1%) favorable treatment response was achieved, while the dissociation between immunological and virological responses to HAART occurred in 121 (14.4%). A baseline CD4+ T-cell counts above 200 cells/mL was the single independent predictor of a favorable treatment response (HR = 2, 95%CI = 1.69-2.61, P = 0.001), while pre-treatment with ART, HCV co-infection and AIDS at the time of treatment initiation, were all factors preventing a favorable response (HR = 0.27, 95% CI = 0.19-0.36, P = 0.001; HR = 0.75, 95% CI = 0.56-0.95, P = 0.02; HR = 0.73, 95% CI = 0.17-0.95, P = 0.018, respectively). A sustained viral suppression was an independent predictor of survival (HR = 0.2, 95% CI 0.07-0.61, P = 0.004). HAART treated HIV-infected patients who reach and maintain undetectable viremia, have an 80% probability of a 14-years survival (P = 0.08, log-rank). Conclusion: If patient with advanced HIV-related immunodeficiency reach and maintain optimal viral suppression during HAART, regardless of the level of immune recovery, and if they continue to maintain this, their prognosis may be fairly good even in the resource-limited settings. PB - Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux T2 - Biomedicine & Pharmacotherapy T1 - Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study EP - 395 IS - 3 SP - 391 VL - 68 DO - 10.1016/j.biopha.2014.01.001 ER -
@article{ author = "Jevtović, Đorđe and Dragović, Gordana and Salemović, Dubravka and Ranin, Jovan and Kusić, Jovana and Marinković, Jelena and Đurković-Đaković, Olgica", year = "2014", abstract = "Introduction: We evaluated the effects of highly-active-antiretroviral-therapy (HAART) in a resource-limited settings. Methods: A cross-sectional study was performed in patients who had initiated HAART at the HIV/AIDS-Center, Belgrade, Serbia. Treatment response was considered favorable in case of the achievement of undetectable HIVRNA plasma-viral-load (pVL lt 50 copies/mu L), and with the CD4+ T-cell counts increased above 350 cells/mu L. The treatment failure was defined as pVL over 1.7 log(10) copies/mL, regardless of immunological improvement. Results: Eight hundred and forty HIV infected patients were followed-up for 8.2 +/- 3.4 years. Out of 697 patients available for follow-up, 113 (16.2%) patients died, 44 (6.3%) experienced treatment failure, while 540 (77.5%) had sustained undetectable viremia. In 419 (60.1%) favorable treatment response was achieved, while the dissociation between immunological and virological responses to HAART occurred in 121 (14.4%). A baseline CD4+ T-cell counts above 200 cells/mL was the single independent predictor of a favorable treatment response (HR = 2, 95%CI = 1.69-2.61, P = 0.001), while pre-treatment with ART, HCV co-infection and AIDS at the time of treatment initiation, were all factors preventing a favorable response (HR = 0.27, 95% CI = 0.19-0.36, P = 0.001; HR = 0.75, 95% CI = 0.56-0.95, P = 0.02; HR = 0.73, 95% CI = 0.17-0.95, P = 0.018, respectively). A sustained viral suppression was an independent predictor of survival (HR = 0.2, 95% CI 0.07-0.61, P = 0.004). HAART treated HIV-infected patients who reach and maintain undetectable viremia, have an 80% probability of a 14-years survival (P = 0.08, log-rank). Conclusion: If patient with advanced HIV-related immunodeficiency reach and maintain optimal viral suppression during HAART, regardless of the level of immune recovery, and if they continue to maintain this, their prognosis may be fairly good even in the resource-limited settings.", publisher = "Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux", journal = "Biomedicine & Pharmacotherapy", title = "Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study", pages = "395-391", number = "3", volume = "68", doi = "10.1016/j.biopha.2014.01.001" }
Jevtović, Đ., Dragović, G., Salemović, D., Ranin, J., Kusić, J., Marinković, J.,& Đurković-Đaković, O.. (2014). Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study. in Biomedicine & Pharmacotherapy Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux., 68(3), 391-395. https://doi.org/10.1016/j.biopha.2014.01.001
Jevtović Đ, Dragović G, Salemović D, Ranin J, Kusić J, Marinković J, Đurković-Đaković O. Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study. in Biomedicine & Pharmacotherapy. 2014;68(3):391-395. doi:10.1016/j.biopha.2014.01.001 .
Jevtović, Đorđe, Dragović, Gordana, Salemović, Dubravka, Ranin, Jovan, Kusić, Jovana, Marinković, Jelena, Đurković-Đaković, Olgica, "Treatment outcome of HAART-treated patients in a resource-limited setting: The Belgrade Cohort Study" in Biomedicine & Pharmacotherapy, 68, no. 3 (2014):391-395, https://doi.org/10.1016/j.biopha.2014.01.001 . .