Higher baseline levels of plasma human immunodeficiency virus type 1 RNA are associated with increased mortality after initiation of triple-drug antiretroviral therapy.
We evaluated 1422 antiretroviral therapy (ART)-naive patients infected with human immunodeficiency virus (HIV) who initiated highly active antiretroviral therapy between 1 August 1 1996 and 31 July 2000 and were monitored until 31 March 2002. Patients were stratified on the basis of baseline levels of HIV RNA (<50,000, 50,000-99,999, and > or =100,000 copies/mL). Cox regression was used to determine independent predictors of time to death. After adjustment for adherence to ART and other potential confounders, baseline levels of HIV RNA of > or =100,000 copies/mL remained independently associated with mortality (adjusted relative hazard, 1.71; 95% confidence interval, 1.08-2.70; P=.023). If appropriately confirmed, these findings have important implications for the development of therapeutic guidelines.
Wood
Evan
E
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, and Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada. ewood@hivnet.ubc.ca.
Hogg
Robert S
RS
Yip
Benita
B
Quercia
Romina
R
Harrigan
P Richard
PR
O'Shaughnessy
Michael V
MV
Montaner
Julio S G
JS
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000821:virology*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors