Dataset Information

When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study.

ABSTRACT:

Objective

To illustrate an approach to compare CD4 cell count and HIV-RNA monitoring strategies in HIV-positive individuals on antiretroviral therapy (ART).

Design

Prospective studies of HIV-positive individuals in Europe and the USA in the HIV-CAUSAL Collaboration and The Center for AIDS Research Network of Integrated Clinical Systems.

Methods

Antiretroviral-naive individuals who initiated ART and became virologically suppressed within 12 months were followed from the date of suppression. We compared 3 CD4 cell count and HIV-RNA monitoring strategies: once every (1) 3 ± 1 months, (2) 6 ± 1 months, and (3) 9-12 ± 1 months. We used inverse-probability weighted models to compare these strategies with respect to clinical, immunologic, and virologic outcomes.

Results

In 39,029 eligible individuals, there were 265 deaths and 690 AIDS-defining illnesses or deaths. Compared with the 3-month strategy, the mortality hazard ratios (95% CIs) were 0.86 (0.42 to 1.78) for the 6 months and 0.82 (0.46 to 1.47) for the 9-12 month strategy. The respective 18-month risk ratios (95% CIs) of virologic failure (RNA >200) were 0.74 (0.46 to 1.19) and 2.35 (1.56 to 3.54) and 18-month mean CD4 differences (95% CIs) were -5.3 (-18.6 to 7.9) and -31.7 (-52.0 to -11.3). The estimates for the 2-year risk of AIDS-defining illness or death were similar across strategies.

Conclusions

Our findings suggest that monitoring frequency of virologically suppressed individuals can be decreased from every 3 months to every 6, 9, or 12 months with respect to clinical outcomes. Because effects of different monitoring strategies could take years to materialize, longer follow-up is needed to fully evaluate this question.

SUBMITTER: Caniglia EC

PROVIDER: S-EPMC4866894 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Publications

When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study.

Caniglia Ellen C EC Sabin Caroline C Robins James M JM Logan Roger R Cain Lauren E LE Abgrall Sophie S Mugavero Michael J MJ Hernandez-Diaz Sonia S Meyer Laurence L Seng Remonie R Drozd Daniel R DR Seage George R GR Bonnet Fabrice F Dabis Francois F Moore Richard R RR Reiss Peter P van Sighem Ard A Mathews William C WC Del Amo Julia J Moreno Santiago S Deeks Steven G SG Muga Roberto R Boswell Stephen L SL Ferrer Elena E Eron Joseph J JJ Napravnik Sonia S Jose Sophie S Phillips Andrew A Olson Ashley A Justice Amy C AC Tate Janet P JP Bucher Heiner C HC Egger Matthias M Touloumi Giota G Sterne Jonathan A JA Costagliola Dominique D Saag Michael M Hernán Miguel A MA

Journal of acquired immune deficiency syndromes (1999) 20160601 2

<h4>Objective</h4>To illustrate an approach to compare CD4 cell count and HIV-RNA monitoring strategies in HIV-positive individuals on antiretroviral therapy (ART).<h4>Design</h4>Prospective studies of HIV-positive individuals in Europe and the USA in the HIV-CAUSAL Collaboration and The Center for AIDS Research Network of Integrated Clinical Systems.<h4>Methods</h4>Antiretroviral-naive individuals who initiated ART and became virologically suppressed within 12 months were followed from the date ...[more]

PMID: 26895294

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Dataset Information

When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study.

Objective

Design

Methods

Results

Conclusions

Publications

When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study.

Similar Datasets

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