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Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe

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Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe. / Zoufaly, Alexander; Cozzi-Lepri, Alessandro; Reekie, Joanne; Kirk, Ole; Lundgren, Jens; Reiss, Peter; Jevtovic, Djordje; Machala, Ladislav; Zangerle, Robert; Mocroft, Amanda; Van Lunzen, Jan; EuroSIDA in EuroCoord.

In: PLOS ONE, Vol. 9, No. 1, 31.01.2014, p. e87160.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Zoufaly, A, Cozzi-Lepri, A, Reekie, J, Kirk, O, Lundgren, J, Reiss, P, Jevtovic, D, Machala, L, Zangerle, R, Mocroft, A, Van Lunzen, J & EuroSIDA in EuroCoord 2014, 'Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe', PLOS ONE, vol. 9, no. 1, pp. e87160. https://doi.org/10.1371/journal.pone.0087160

APA

Zoufaly, A., Cozzi-Lepri, A., Reekie, J., Kirk, O., Lundgren, J., Reiss, P., Jevtovic, D., Machala, L., Zangerle, R., Mocroft, A., Van Lunzen, J., & EuroSIDA in EuroCoord (2014). Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe. PLOS ONE, 9(1), e87160. https://doi.org/10.1371/journal.pone.0087160

Vancouver

Zoufaly A, Cozzi-Lepri A, Reekie J, Kirk O, Lundgren J, Reiss P et al. Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe. PLOS ONE. 2014 Jan 31;9(1):e87160. https://doi.org/10.1371/journal.pone.0087160

Bibtex

@article{38d8cad4e1994e85b7c71d667d04269e,
title = "Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe",
abstract = "BACKGROUND: The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated.METHODS: Patients in EuroSIDA starting at least 1 new antiretroviral drug with CD4<350 cells/µl and viral load (VL)>500 copies/mL were followed-up from the first day of VL< = 50 copies/ml until a new fatal/non-fatal non-AIDS/AIDS event. Considered non-AIDS events included non-AIDS malignancies, pancreatitis, severe liver disease with hepatic encephalopathy (>grade 3), cardio- and cerebrovascular events, and end-stage renal disease. Patients were classified over time according to whether current CD4 count was above (non-ID) or below (ID) baseline level. Relative rates (RR) of events were calculated for ID vs. non-ID using adjusted Poisson regression models.RESULTS: 2,913 patients contributed 11,491 person-years for the analysis of non-AIDS. 241 pre-specified non-AIDS events (including 84 deaths) and 89 AIDS events (including 10 deaths) occurred. The RR of developing pre-specified non-AIDS events for ID vs. non-ID was 1.96 (95% CI 1.37-2.81, p<0.001) in unadjusted analysis and 1.43 (0.94-2.17, p = 0.095) after controlling for current CD4 count. ID was not associated with the risk of AIDS events (aRR 0.76, 95% CI 0.41-1.38, p = 0.361).CONCLUSION: Compared to CD4 responders, patients with immuno-virological discordance may be at increased risk of developing non-AIDS events. Further studies are warranted to establish whether in patients with ID, strategies to directly modify CD4 count response may be needed besides the use of ART.",
author = "Alexander Zoufaly and Alessandro Cozzi-Lepri and Joanne Reekie and Ole Kirk and Jens Lundgren and Peter Reiss and Djordje Jevtovic and Ladislav Machala and Robert Zangerle and Amanda Mocroft and {Van Lunzen}, Jan and {EuroSIDA in EuroCoord}",
year = "2014",
month = jan,
day = "31",
doi = "10.1371/journal.pone.0087160",
language = "English",
volume = "9",
pages = "e87160",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "1",

}

RIS

TY - JOUR

T1 - Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe

AU - Zoufaly, Alexander

AU - Cozzi-Lepri, Alessandro

AU - Reekie, Joanne

AU - Kirk, Ole

AU - Lundgren, Jens

AU - Reiss, Peter

AU - Jevtovic, Djordje

AU - Machala, Ladislav

AU - Zangerle, Robert

AU - Mocroft, Amanda

AU - Van Lunzen, Jan

AU - EuroSIDA in EuroCoord

PY - 2014/1/31

Y1 - 2014/1/31

N2 - BACKGROUND: The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated.METHODS: Patients in EuroSIDA starting at least 1 new antiretroviral drug with CD4<350 cells/µl and viral load (VL)>500 copies/mL were followed-up from the first day of VL< = 50 copies/ml until a new fatal/non-fatal non-AIDS/AIDS event. Considered non-AIDS events included non-AIDS malignancies, pancreatitis, severe liver disease with hepatic encephalopathy (>grade 3), cardio- and cerebrovascular events, and end-stage renal disease. Patients were classified over time according to whether current CD4 count was above (non-ID) or below (ID) baseline level. Relative rates (RR) of events were calculated for ID vs. non-ID using adjusted Poisson regression models.RESULTS: 2,913 patients contributed 11,491 person-years for the analysis of non-AIDS. 241 pre-specified non-AIDS events (including 84 deaths) and 89 AIDS events (including 10 deaths) occurred. The RR of developing pre-specified non-AIDS events for ID vs. non-ID was 1.96 (95% CI 1.37-2.81, p<0.001) in unadjusted analysis and 1.43 (0.94-2.17, p = 0.095) after controlling for current CD4 count. ID was not associated with the risk of AIDS events (aRR 0.76, 95% CI 0.41-1.38, p = 0.361).CONCLUSION: Compared to CD4 responders, patients with immuno-virological discordance may be at increased risk of developing non-AIDS events. Further studies are warranted to establish whether in patients with ID, strategies to directly modify CD4 count response may be needed besides the use of ART.

AB - BACKGROUND: The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated.METHODS: Patients in EuroSIDA starting at least 1 new antiretroviral drug with CD4<350 cells/µl and viral load (VL)>500 copies/mL were followed-up from the first day of VL< = 50 copies/ml until a new fatal/non-fatal non-AIDS/AIDS event. Considered non-AIDS events included non-AIDS malignancies, pancreatitis, severe liver disease with hepatic encephalopathy (>grade 3), cardio- and cerebrovascular events, and end-stage renal disease. Patients were classified over time according to whether current CD4 count was above (non-ID) or below (ID) baseline level. Relative rates (RR) of events were calculated for ID vs. non-ID using adjusted Poisson regression models.RESULTS: 2,913 patients contributed 11,491 person-years for the analysis of non-AIDS. 241 pre-specified non-AIDS events (including 84 deaths) and 89 AIDS events (including 10 deaths) occurred. The RR of developing pre-specified non-AIDS events for ID vs. non-ID was 1.96 (95% CI 1.37-2.81, p<0.001) in unadjusted analysis and 1.43 (0.94-2.17, p = 0.095) after controlling for current CD4 count. ID was not associated with the risk of AIDS events (aRR 0.76, 95% CI 0.41-1.38, p = 0.361).CONCLUSION: Compared to CD4 responders, patients with immuno-virological discordance may be at increased risk of developing non-AIDS events. Further studies are warranted to establish whether in patients with ID, strategies to directly modify CD4 count response may be needed besides the use of ART.

U2 - 10.1371/journal.pone.0087160

DO - 10.1371/journal.pone.0087160

M3 - SCORING: Journal article

C2 - 24498036

VL - 9

SP - e87160

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 1

ER -