Postgraduate Programme Biostatistics & Health Science Data
Library of the School of Health Sciences

2017-07-05

2017

Kouvelakis Kyriakos

Παναγιώτα Τουλούμη, Αναπληρώτρια καθηγήτρια Βιοστατιστικής και Επιδημιολογίας, Ιατρική Σχολή, ΕΚΠΑ
Βασιλική-Αναστασία Σύψα. Λέκτορας Επιδημιολογίας και Προληπτικής Ιατρικής, ΕΚΠΑ
Κωνσταντίνος Γιαννούτσος, Καθηγητής, Indiana University R.M. Fairbanks. School of Public Health

Εκτίμηση θνησιμότητας σε ασθενείς με HIV λοίμωξη μετά την έναρξη αντιρετροϊκής θεραπείας

English

Estimation of mortality after initiation of antiretroviral therapy in patients with HIV infection

Background and Objectives: The aim was to produce mortality rate estimates in HIV-infected patients in Europe after initiation of antiretroviral therapy (ART). Mortality estimates were analyzed by gender, age category, CD4 count at initiation of ART and months on ART in order to evaluate the effect of these covariates on the hazard of death.
Methods: Demographic and longitudinal clinical data from 4,941 patients from the Eurosida cohort with access to HIV care in clinical centers from Western and Eastern Europe were sent by the COHERE organization. Data were subsequently processed for the conduction of survival analysis with time of origin for every patient the earliest date of initiation of ART and the last date known alive as the last date of follow-up. Two separate Poisson regression models containing the factors CD4 category at ART start, gender, age category and duration of therapy were fitted to the observed data; the first for the first 6 months of therapy and the second from 7 months onwards.
Results: A large proportion of patients (38.96%) entered ART with low CD4 lymphocyte counts (<200 cells/μl). Mortality was estimated to be highest in patients with the highest degree of immunosupression at the start of treatment, as indicated by a low CD4 count, particularly during the first 6 months of therapy. Male gender and age over than 45 years seem also to be associated with an increased risk of death.
Discussion and Conclusions: The role of the CD4 count at initiation of ART as a prognostic factor was highlighted in this analysis. Patients with low CD4 count die at a higher rate than patients with higher CD4 counts and it is worrying that a large number of HIV-infected patients still enter therapy with low CD4 counts in the European setting.

Health Sciences

Mortality, HIV, AIDS, Antiretroviral therapy, CD4 lymphocytes

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https://pergamos.lib.uoa.gr/uoa/dl/object/1701887