Unregistered User If this is not your name, click here.
		Contact Us | Order Now | Journals | Bookstore | Register a colleague
	Select a ChannelAcneAIDS and HIVAllergy OtherAlzheimer'sAnaesthesiology OtherAngina Pectoris/MIAnxietyArthritis OtherAsthmaBack PainBacterial InfectionsBladder CancerBone Marrow TransplantationBreast CancerCardiology OtherCataractCell TransplantationCervical CancerCholesterol/Lipid disordersCirrhosisClinical PharmacologyColorectal CancerCongestive Heart FailureContact DermatitisContraceptionCOPDCystic FibrosisDental and Oral DisordersDepressionDermatology OtherDiabetesDialysisEating DisordersElbowEmergency MedicineEndocrinology OtherEpilepsyErectile DysfunctionFibromyalgiaGastro OtherGeneticsGenitourinary OtherGeriatricsGERD/GastritisGlaucomaH. Pylori/UlcerHaematology OtherHair LossHeadachesHepa/Biliary OtherHepatitisHipHRTHypertensionIBDImmunologyInfectious OtherInfertilityIntensive CareIrritable Bowel SyndromeKneeLeukemiasLiver CancerLung CancerLupusLymphomasMelanomaMenopauseMultiple Sclerosis Nephrology OtherNeurologic OtherNutritional / Metabolic OtherOb/Gyn OtherObesityOncology OtherOphth. OtherOphthalmic SurgeryOrgan TransplantationOrthopaedics OtherOsteoarthritisOsteoporosisOtitisOtorhino. OtherOvarian CancerPaediatricsPainPancreatic CancerParkinson'sPregnancyProstate CancerPsychiatry OtherPulmonary OtherRadiologyRenal CancerRenal FailureRespiratory InfectionsRheumatoid arthritisRheumatology OtherRhinitisSchizophreniaShoulderSleep ApnoeaSleep DisordersSpineStrokeSTDsSurgeryThyroid DisordersTransfusionTransplant Surgery OtherTraumaUrinary IncontinenceUrinary tract infectionsVaccinologyVascular DisordersViral Infections

SEARCH   News Bookstore Medline The Web Meetings & Congresses Complete Doctor's Guide    EXPLORE :    All News   All Webcasts   All Cases   All Meetings & Congresses   All Medical Resources New drugs / indications English Dictionary Medical Dictionary Thesaurus Warning | Privacy | Awards  Favourite Journals  Click here to choose your favourite journals  Favourite Sites  Click here to choose your favourite sites  Languages  Select languageEnglishFrançais

Higher Risk of Death for Treatment-Naive HIV Patients With High CD4-Positive Cell Counts: Presented at CROI By Maria Bishop BOSTON, MA -- February 11, 2008 -- Despite having CD4-positive cell counts above the currently recommended threshold for starting treatment, HIV-infected patients who are naive to antiretroviral therapy (ART) have higher death rates compared with the general population, according to the results of a trial presented here at the 15th Conference on Retroviruses and Opportunistic Infections (CROI). Rebecca Lodwick, HIV Research Statistician, Primary Care and Population Sciences Department, Network, University College London, London, United Kingdom, led a team in utilizing data from 23 cohorts to calculate country-, age-, and sex-standardized mortality ratios, stratifying subjects by risk group. All subjects were ART-naive and had at least one CD4-positive cell count greater than 350 cells/mm3. Follow-up was counted from the time of each CD4-positive cell count greater than 350 cells/mm3 until the earliest next CD4-positive cell count, elapse of 1 year, death, or start of ART. Where available, the most recent viral load value at the time of each CD4-positive cell count was identified. Among 46,400 patients contributing 98,527 person-years of follow-up with current CD4-positive cell count greater than 350 cells/mm3, 487 subjects (1.04%) died during the study period, Lodwick said during her presentation on February 6. About 16% of these deaths were known to be AIDS-related and 48% were non-AIDS-related, but the cause was unknown for more than one third of deaths. Most patients were men (75%), 50% were men who have sex with men, 21% were heterosexual, 21% were injecting drug users, and 5% were in the "other" or "unknown" risk group. After adjustment for age and gender risk, however, a higher CD4-positive cell count was associated with a decreased risk of death (per 2-fold higher CD4-positive cell count: incidence rate ratio 0.66; 95% confidence interval [CI] 0.54-0.81; P <.0001, Poisson regression). Andrew Phillips, PhD, Professor of Epidemiology and Biostatistics, University College London, London, United Kingdom, noted that, although the death rate overall was higher than that of the general population, the difference was marginal for men who have sex with men. Heterosexual men and women as a group were found to have a risk of death 3 times higher than that of the general population. For injection drug users, the risk was 10 times greater. This suggests that some of the raised risk may be due to confounding by other factors outside of HIV disease status. Similarly, in 66,665 person-years where a viral load was available, a higher viral load was associated with an increased risk of death (per log10 increase: incidence risk ratio 1.17; 95% CI 1.03-1.34; P <.0001). Even in this high CD4-positive cell count range, however, lower CD4-positive cell count and higher viral load were associated with increased mortality. Although several cohorts are linked with national death records, the researchers stated, it is plausible that under-ascertainment or late reporting of deaths has resulted in under-estimation of death rates. Perhaps, noted Dr. Phillips, HIV itself may cause some increase in mortality -- even for people with relatively healthy immune function. [Presentation title: Age- and Sex-Specific Death Rates in ART-Naïve Patients With CD4 Count Above 350 cells/mm3 Compared With the General Population. Abstract 141] E-mail this page to a friend or colleague! To print, use this version