Sökning: id:"swepub:oai:gup.ub.gu.se/255761" >
Virological failure...
Virological failure and all-cause mortality in HIV-positive adults with low-level viremia during antiretroviral treatment
-
- Elvstam, Olof (författare)
- Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups
-
- Medstrand, Patrik (författare)
- Lund University,Lunds universitet,Klinisk virologi, Malmö,Forskargrupper vid Lunds universitet,Clinical Virology, Malmö,Lund University Research Groups
-
- Yilmaz, Aylin, 1974 (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
-
visa fler...
-
- Isberg, Per Erik (författare)
- Lund University,Lunds universitet,Statistiska institutionen,Ekonomihögskolan,Department of Statistics,Lund University School of Economics and Management, LUSEM
-
- Gisslén, Magnus, 1962 (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
-
- Bjorkman, Per (författare)
- Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups
-
visa färre...
-
(creator_code:org_t)
- 2017-07-06
- 2017
- Engelska.
-
Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:7
- Relaterad länk:
-
https://journals.plo...
-
visa fler...
-
http://dx.doi.org/10... (free)
-
https://gup.ub.gu.se...
-
https://doi.org/10.1...
-
https://lup.lub.lu.s...
-
visa färre...
Abstract
Ämnesord
Stäng
- Objective Although most HIV-infected individuals achieve undetectable viremia during antiretroviral therapy (ART), a subset have low-level viremia (LLV) of varying duration and magnitude. The impact of LLV on treatment outcomes is unclear. We investigated the association between LLV and virological failure and/or all-cause mortality among Swedish patients receiving ART. HIV-infected patients from two Swedish HIV centers were identified from the nationwide register InfCare HIV. Subjects aged >= 15 years with triple agent ART were included at 12 months after treatment initiation if >= 2 following viral load measurements were available. Patients with 2 consecutive HIV RNA values >= 1000 copies/mL at this time point were excluded. Participants were stratified into four categories depending on viremia profiles: permanently suppressed viremia (<50 copies/mL), LLV 50-199 copies/mL, LLV 200-999 copies/mL and viremia >= 1000 copies/mL. Association between all four viremia categories and all-cause death was calculated using survival analysis with viremia as a time-varying covariate, so that patients could change viremia category during follow-up. Association between the three lower categories and virological failure >= 2 consecutive measurements >= 1000 copies/mL) was calculated in a similar manner. LLV 50-199 copies/mL was recorded in 70/1015 patients (6.9%) and LLV 200-999 copies/mL in 89 (8.8%) during 7812 person-years of follow-up (median 6.5 years). LLV 200-999 copies/mL was associated with virological failure (adjusted hazard ratio 3.14 [95% confidence interval 1.41-7.03, p<0.01]), whereas LLV 50-199 copies/mL was not (1.01 [0.34-4.31, p = 0.99]; median follow-up 4.5 years). LLV 200-999 copies/mL had an adjusted mortality hazard ratio of 2.29 (0.98-5.32, p = 0.05) and LLV 50-199 copies/mL of 2.19 (0.90-5.37, p = 0.09). In this Swedish cohort followed during ART for a median of 4.5 years, LLV 200-999 copies/mL was independently associated with virological failure. Patients with LLV had higher rates of all-cause mortality, although not statistically significant in multivariate analysis.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- hiv-1-infected patients
- infected patients
- drug-resistance
- raltegravir
- intensification
- general-population
- copy-years
- therapy
- cohort
- inflammation
- risk
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
-
Plos One
(Sök värdpublikationen i LIBRIS)
Till lärosätets databas