Abstract | OBJECTIVES: Certain non- AIDS-related diseases have been associated with immunodeficiency and HIV RNA levels in HIV-infected patients on combination antiretroviral therapy (cART). We aimed to investigate these associations in patients not yet on cART, when potential antiretroviral-drug-related effects are absent and variation in RNA levels is greater. METHODS: RESULTS: During 18 646 person-years of follow-up, 203 non- AIDS-related events occurred. Compared with a CD4 count ≥ 500 cells/μL, adjusted relative risks (RRs) for the composite endpoint were 4.71 [95% confidence interval (CI) 2.98-7.45] for a CD4 count < 200 cells/μL, 2.06 (95% CI 1.38-3.06) for a CD4 count of 200-349 cells/μL, and 1.19 (95% CI 0.82-1.74) for a CD4 count of 350-499 cells/μL. There was no evidence for an independent association with HIV RNA. Other important covariates were age [RR 1.40 (95% CI 1.31-1.49) per 5 years older], hepatitis B virus coinfection [RR 5.66 (95% CI 3.87-8.28)] and hepatitis C virus coinfection [RR 9.26 (95% CI 6.04-14.2)]. CONCLUSIONS: In persons not yet receiving cART, a more severe degree of immunodeficiency rather than higher HIV RNA levels appears to be associated with an increased risk of our composite non- AIDS-related endpoint. Larger studies are needed to address these associations for individual non- AIDS-related events.
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Authors | S Zhang, A van Sighem, A Kesselring, L Gras, J M Prins, E Hassink, R Kauffmann, C Richter, F de Wolf, P Reiss, ATHENA national observational HIV cohort study |
Journal | HIV medicine
(HIV Med)
Vol. 16
Issue 5
Pg. 265-72
(May 2015)
ISSN: 1468-1293 [Electronic] England |
PMID | 25604160
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Copyright | © 2015 British HIV Association. |
Chemical References |
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Topics |
- Adult
- CD4 Lymphocyte Count
- Cardiovascular Diseases
(epidemiology, immunology, prevention & control)
- Coinfection
- Female
- Follow-Up Studies
- HIV Infections
(complications, epidemiology, immunology)
- Hepatitis B
(epidemiology, immunology)
- Hepatitis C
(epidemiology, immunology)
- Humans
- Immunocompromised Host
(immunology)
- Liver Diseases
(epidemiology, immunology, prevention & control)
- Male
- Neoplasms
(epidemiology, immunology, prevention & control)
- Netherlands
(epidemiology)
- RNA, Viral
- Risk Factors
- Viral Load
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