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Factors Associated with the Development of Opportunistic Infections in HIV‐1–Infected Adults with High CD4+Cell Counts: A EuroSIDA Study


Podlekareva, Daria; Mocroft, Amanda; Dragsted, Ulrik B; Ledergerber, Bruno; Beniowski, Marek; Lazzarin, Adriano; Weber, Jonathan; Clumeck, Nathan; Vetter, Norbert; Phillips, Andrew; Lundgren, Jens D (2006). Factors Associated with the Development of Opportunistic Infections in HIV‐1–Infected Adults with High CD4+Cell Counts: A EuroSIDA Study. Journal of Infectious Diseases, 194(5):633-641.

Abstract

BackgroundLimited data exist on factors predicting the development of opportunistic infections (OIs) at higher-than-expected CD4+ cell counts in human immunodeficiency virus (HIV) type 1-infected adults MethodsMultivariate Poisson regression models were used to determine factors related to the development of groups of OIs above their respective traditional upper CD4+ cell count thresholds: group 1 (⩾100 cells/μL), OIs caused by cytomegalovirus, Mycobacterium avium complex, and Toxoplasma gondii; group 2 (⩾200 cells/μL), Pneumocystis pneumonia and esophageal candidiasis; and group 3 (⩾300 cells/μL), pulmonary and extrapulmonary tuberculosis ResultsIn groups 1, 2, and 3, 71 of 9219, 125 of 7934, and 36 of 7838 patients, respectively, developed ⩾1 intragroup OI. The strongest predictor of an OI in groups 1 and 2 was current CD4+ cell count (for group 1, incidence rate ratio [IRR] per 50% lower CD4+ cell count, 5.37 [95% confidence interval {CI}, 3.71-7.77]; for group 2, 4.28 [95% CI, 2.98-6.14]). Injection drug use but not current CD4+ cell count predicted risk in group 3. Use of antiretroviral treatment was associated with a lower incidence of OIs in all groups, likely by reducing HIV-1 RNA levels (IRR per 1-log10 copies/mL higher HIV-1 RNA levels for group 1, 1.50 [95% CI, 1.15-1.95]; for group 2, 1.68 [95% CI, 1.40-2.02]; and for group 3, 1.89 [95% CI, 1.40-2.54]) ConclusionAlthough the absolute incidence is low, the current CD4+ cell count and HIV-1 RNA level are strong predictors of most OIs in patients with high CD4+ cell counts

Abstract

BackgroundLimited data exist on factors predicting the development of opportunistic infections (OIs) at higher-than-expected CD4+ cell counts in human immunodeficiency virus (HIV) type 1-infected adults MethodsMultivariate Poisson regression models were used to determine factors related to the development of groups of OIs above their respective traditional upper CD4+ cell count thresholds: group 1 (⩾100 cells/μL), OIs caused by cytomegalovirus, Mycobacterium avium complex, and Toxoplasma gondii; group 2 (⩾200 cells/μL), Pneumocystis pneumonia and esophageal candidiasis; and group 3 (⩾300 cells/μL), pulmonary and extrapulmonary tuberculosis ResultsIn groups 1, 2, and 3, 71 of 9219, 125 of 7934, and 36 of 7838 patients, respectively, developed ⩾1 intragroup OI. The strongest predictor of an OI in groups 1 and 2 was current CD4+ cell count (for group 1, incidence rate ratio [IRR] per 50% lower CD4+ cell count, 5.37 [95% confidence interval {CI}, 3.71-7.77]; for group 2, 4.28 [95% CI, 2.98-6.14]). Injection drug use but not current CD4+ cell count predicted risk in group 3. Use of antiretroviral treatment was associated with a lower incidence of OIs in all groups, likely by reducing HIV-1 RNA levels (IRR per 1-log10 copies/mL higher HIV-1 RNA levels for group 1, 1.50 [95% CI, 1.15-1.95]; for group 2, 1.68 [95% CI, 1.40-2.02]; and for group 3, 1.89 [95% CI, 1.40-2.54]) ConclusionAlthough the absolute incidence is low, the current CD4+ cell count and HIV-1 RNA level are strong predictors of most OIs in patients with high CD4+ cell counts

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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:1 September 2006
Deposited On:19 Sep 2018 15:23
Last Modified:17 Sep 2019 19:28
Publisher:Oxford University Press
ISSN:0022-1899
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1086/506366
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicenceoxford101086506366 (Library Catalogue)

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