دورية أكاديمية

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

التفاصيل البيبلوغرافية
العنوان: Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach
المؤلفون: Massiá, Mar, Padilla, Sergio, Moreno, Santiago, Barber, Xavier, Iribarren, José A., Romero, Jorge del, Gómez-Sirvent, Juan L., Rivero, María, Vidal, Francesc, Campins, Antonio A., Gutiérrez, Félix
المساهمون: Instituto de Salud Carlos III, European Commission
بيانات النشر: Public Library of Science
سنة النشر: 2017
المجموعة: Digital.CSIC (Consejo Superior de Investigaciones Científicas / Spanish National Research Council)
الوصف: Cohorte de la Red de InvestigacioÂn en Sida (CoRIS). ; [Objetives] Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. ; [Design] Prospective multicenter cohort study. ; [Methods] Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced (“NAE development”); from alive and NAE-experienced to death (“Death after NAE”); and from alive and NAE-free to death (“Death without NAE”). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition “Death after NAE”. ; [Results] 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80–30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition “Death after NAE” was 12.1 (95%CI, 4.90–29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45–6.57) for intermediate-severity; and 9.85 (5.45–17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11–3.84), age>50 years (1.78, 1.08–2.94), hepatitis C-coinfection (2.52, 1.38–4.61), lower CD4 cell count at cohort entry (HR 2.49; 95%CI 1.20–5.14 for CD4 cell count below 200 and HR 2.16; 95%CI 1.01–4.66 for CD4 cell count between 200–350, both compared to CD4 cell count higher than 500) and concomitant CD4<200 cells/mL (2.22, 1.42–3.44) were associated with death after NAE. CD4 count and HIV-1 RNA at engagement, previous AIDS and hepatitis C-coinfection predicted mortality in NAE-free ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
تدمد: 1932-6203
العلاقة: Publisher's version; https://doi.org/10.1371/journal.pone.0184329Test; Sí; PLoS ONE 12(9): e0184329 (2017); http://hdl.handle.net/10261/180806Test; http://dx.doi.org/10.13039/501100004587Test; http://dx.doi.org/10.13039/501100000780Test
DOI: 10.1371/journal.pone.0184329
DOI: 10.13039/501100004587
DOI: 10.13039/501100000780
الإتاحة: https://doi.org/10.1371/journal.pone.0184329Test
https://doi.org/10.13039/501100004587Test
https://doi.org/10.13039/501100000780Test
http://hdl.handle.net/10261/180806Test
حقوق: open
رقم الانضمام: edsbas.CF24D037
قاعدة البيانات: BASE
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0184329