Abstract | OBJECTIVE: DESIGN: Prospective observational cohort study. METHODS: HIV-1-seropositive subjects followed-up in HIV centres of Bordeaux University Hospital, Southwest France who were prescribed at least one available protease inhibitor between January and December 1996 were included in this analysis. A Cox model estimated the independent effect of baseline covariates and CD4+ cell response, considered as a time-dependent covariate, on the occurrence of new AIDS-defining opportunistic infection, new AIDS-defining events, new AIDS-defining opportunistic infection or death. RESULTS: A total of 556 HIV-positive patients were prescribed at least one protease inhibitor: 34% saquinavir, 52% indinavir, and 14% ritonavir. Median CD4+ cell count at baseline was 95 x 10(6)/l and mean plasma HIV RNA was 5.0 log10 copies/ml. After a median follow-up of 230 days, 65 patients experienced a new episode of opportunistic infection, 79 patients experienced at least one AIDS-defining event, and 24 had died. On average, the increase in CD4+ cell count was 42 x 10(6)/l (SD, 74) after a median of 49 days. In the multivariate analysis of opportunistic infection or death, each 50% higher CD4+ cell count at baseline was associated with a 23% reduction [95% confidence interval (CI), 14-30] of risk. Each 50% increase in CD4+ cell count during follow-up was associated with a 9% reduction (95% CI, 2-15) of risk, adjusted for the presence of AIDS prior to protease inhibitor therapy (hazard ratio, 3.76 versus absence of AIDS; P < 0.01) and haemoglobin level (hazard ratio, 0.48 if > 11 g/dl versus <11 g/dl; P < 0.01). CONCLUSION: Our results show, at least indirectly, how protease inhibitors might produce clinical stabilization. This result may be due to improved functionality of CD4+ cells in patients started on protease inhibitors.
|
Authors | G Chêne, C Binquet, J F Moreau, D Neau, I Pellegrin, D Malvy, J Ceccaldi, D Lacoste, F Dabis |
Journal | AIDS (London, England)
(AIDS)
Vol. 12
Issue 17
Pg. 2313-20
(Dec 03 1998)
ISSN: 0269-9370 [Print] England |
PMID | 9863874
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Anti-HIV Agents
- HIV Protease Inhibitors
- Indinavir
- Saquinavir
- Ritonavir
|
Topics |
- AIDS-Related Opportunistic Infections
(prevention & control)
- Adult
- Anti-HIV Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Cohort Studies
- Disease Progression
- Female
- Follow-Up Studies
- HIV Infections
(drug therapy, immunology, mortality)
- HIV Protease Inhibitors
(therapeutic use)
- Humans
- Indinavir
(adverse effects, therapeutic use)
- Male
- Predictive Value of Tests
- Prospective Studies
- Risk Factors
- Ritonavir
(adverse effects, therapeutic use)
- Saquinavir
(adverse effects, therapeutic use)
|