Association of self-reported race with AIDS death in continuous HAART users in a cohort of HIV-infected women in the United States

• Objective:To assess the association of race with clinical outcomes in HIV-positive women on continuous HAART.Design:Prospective study that enrolled women from 1994 to 1995 and 2001 to 2002.Setting:Women's Interagency HIV Study, a community-based cohort in five US cities.Participants:One thousand, four hundred and seventy-one HIV-positive continuous HAART users.Main outcome measures:Times to AIDS and non-AIDS death and incident AIDS-defining illness (ADI) after HAART initiation.Results:In adjusted analyses, black vs. white women had higher rates of AIDS death [adjusted hazard ratio (aHR) 2.14, 95% confidence interval (CI) 1.30, 3.50; P=0.003] and incident ADI (aHR 1.58, 95% CI 1.08, 2.32; P=0.02), but not non-AIDS death (aHR 0.91, 95% CI 0.59, 1.39; P=0.65). Cumulative AIDS death incidence at 10 years was 17.3 and 8.3% for black and white women, respectively. Other significant independent pre-HAART predictors of AIDS death included peak viral load (aHR 1.70 per log(10), 95% CI 1.34, 2.16; P<0.001), nadir CD4(+) cell count (aHR 0.65 per 100cells/l, 95% CI 0.56, 0.76; P<0.001), depressive symptoms by Center for Epidemiology Studies Depression score at least 16 (aHR 2.10, 95% CI 1.51, 2.92; P<0.001), hepatitis C virus infection (aHR 1.57, 95% CI 1.02, 2.40; P=0.04), and HIV acquisition via transfusion (aHR 2.33, 95% CI 1.21, 4.49; P=0.01). In models with time-updated HAART adherence, association of race with AIDS death remained statistically significant (aHR 3.09, 95% CI 1.38, 6.93; P=0.006).Conclusion:In continuous HAART-using women, black women more rapidly died from AIDS or experienced incident ADI than their white counterparts after adjusting for confounders. Future studies examining behavioral and biologic factors in these women may further the understanding of HAART prognosis.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Immunology in the medical area (hsv//eng)

Nyckelord

AIDS

HAART

HIV

race

survival

women

ACTIVE ANTIRETROVIRAL THERAPY

QUALITY-OF-LIFE

CLINICAL-TRIALS

DEPRESSIVE SYMPTOMS

AFRICAN-AMERICANS

HIV-1-INFECTED INDIVIDUALS

VIROLOGICAL RESPONSE

NATIONAL-INSTITUTE

RACIAL DISPARITIES

POSITIVE

PATIENTS

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)