tailieunhanh - Báo cáo y học: "Outcomes of highly active antiretroviral therapy in the context of universal access to healthcare: the U.S. Military HIV Natural History Study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Outcomes of highly active antiretroviral therapy in the context of universal access to healthcare: the . Military HIV Natural History Study. | Marconi et al. AIDS Research and Therapy 2010 7 14 http content 7 1 14 AIDS RESEARCH AND THERAPY RESEARCH Open Access Outcomes of highly active antiretroviral therapy in the context of universal access to healthcare the . Military HIV Natural History Study Vincent C Marconi 1 2 8 Greg A Grandits1 3 Amy C Weintrob1 4 Helen Chun1 5 Michael L Landrum1 2 Anuradha Ganesan1 6 Jason F Okulicz1 2 Nancy Crum-Cianflone1 4 Robert J O Connell1 7 Alan Lifson1 3 Glenn WWortmann1 4 Brian KAgan 1 and the Infectious Disease Clinical Research Program HIV Working Group IDCRP Abstract Background To examine the outcomes of highly-active antiretroviral therapy HAART for individuals with free access to healthcare we evaluated 2327 patients in a cohort study composed of military personnel and beneficiaries with HIV infection who initiated HAART from 1996 to the end of 2007. Methods Outcomes analyzed were virologic suppression VS and failure VF CD4 count changes AIDS and death. VF was defined as never suppressing or having at least one rebound event. Multivariate MV analyses stratified by the HAART initiation year before or after 2000 were performed to identify risk factors associated with these outcomes. Results Among patients who started HAART after 2000 81 had VS at 1 year N 1 759 85 at 5 years N 1 061 and 82 at 8 years N 735 . Five years post-HAART the median CD4 increase was 247 cells ml and 34 experienced VF. AIDS and mortality rates at 5 years were 2 and respectively. In a MV model adjusted for known risk factors associated with treatment response being on active duty versus retired at HAART initiation was associated with a decreased risk of AIDS HR 95 CI and mortality an increased probability of CD4 increase 50 but was not significant for VF. Conclusions In this observational cohort VS rates approach those described in clinical trials. Initiating HAART on active duty was associated with even better outcomes. These .