Response to HAART in Treatment-Naive HIV-Infected Patients with a Prior Diagnosis of Tuberculosis or other Opportunistic Infections

Author(s): Fernando Dronda , Paz Sobrino-Vegas , Beatriz Hernandez-Novoa , Ana M. Caro-Murillo , Marta Montero , Jose A. Iribarren , Jesus Sanz , Maria del Mar Alonso , Pablo Labarga , Enrique Bernal , Santiago Moreno1 , CoRIS .

Journal Name: Current HIV Research

Volume 9 , Issue 4 , 2011

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Abstract:

We aimed to evaluate immunological, virological and clinical response to HAART, as well as all-cause mortality, in treatment-naive patients with a diagnosis of tuberculosis (TB) in the prior 6 months, compared to subjects with another AIDS-defining illness (ADI) or event-free individuals in an open, prospective and multicenter hospital-based cohort of HIV-infected naive adults (2004-2008). All cause mortality rates were calculated by Cox regression models. Among 4407 patients, 2400 (54.5%) started HAART: 110 (4.6%) had had previous TB and 414 (17.3%) another ADI. Median time from TB diagnosis to inititation of HAART was 53 days (IQR: 25.75-83.25), and for other ADI was 22 days (IQR: 8-42). Overall, 151 (6.3%) patients developed a new ADI during follow-up; 63% reached virological suppression and 69.4% had increases of ≥50 CD4+/μl, at 6 months. No statistically significant differences were found according to a previous history of TB or another ADI. Overall, 85 subjects died in 4031 person-years of follow-up with a mortality rate of 2.1 (95%CI: 1.7-2.6). When compared to subjects who started HAART in the absence of a previous ADI (HR 1), a prior diagnosis of an ADI other than TB was significantly associated with an increased risk of death. (HR 1.6; 95%CI: 1.1-2.3), but not a diagnosis of TB (HR 1.15; 95%CI: 0.5-2.5). In conclusion, a previous diagnosis of TB or another ADI before HAART did not compromise short-term virological and immunological response to treatment. A prior diagnosis of an ADI different to TB significantly increased all cause mortality.

Keywords: HIV infection, tuberculosis, AIDS defining illness, AIDS, antiretroviral therapy, HAART, CoRIS, Mycobacterium tuberculosis, HIV-1-Infected Patients, CD4+, Short-Term Clinical Outcome

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Article Details

VOLUME: 9
ISSUE: 4
Year: 2011
Page: [229 - 236]
Pages: 8
DOI: 10.2174/157016211796320324
Price: $58

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