Articles producció científica> Medicina i Cirurgia

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

  • Datos identificativos

    Identificador: imarina:5132574
    Autores:
    Masiá M, Padilla S, Moreno S, Barber X, Iribarren JA, Del Romero J, Gómez-Sirvent JL, Rivero M, Vidal F, Campins AA, Gutiérrez F, Cohorte de la Red de Investigación en Sida (CoRIS)
    Resumen:
    OBJETIVES: Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. DESIGN: Prospective multicenter cohort study. METHODS: Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ('NAE development'); from alive and NAE-experienced to death ('Death after NAE'); and from alive and NAE-free to death ('Death without NAE'). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition 'Death after NAE'. RESULTS: 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition 'Death after NAE' was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), age>50 years (1.78, 1.08-2.94), hepatitis C-coinfection (2.52, 1.38-4.61), lower CD4 cell count at cohort entry (HR 2.49; 95%CI 1.20-5.14 for CD4 cell count below 200 and HR 2.16; 95%CI 1.01-4.66 for CD4 cell count between 200-350, both compared to CD4 cell count higher than 500) and concomitant CD4<200 cells/mL
  • Otros:

    Autor según el artículo: Masiá M, Padilla S, Moreno S, Barber X, Iribarren JA, Del Romero J, Gómez-Sirvent JL, Rivero M, Vidal F, Campins AA, Gutiérrez F, Cohorte de la Red de Investigación en Sida (CoRIS)
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: SIRVENT CALVERA, JUAN JOSÉ / Vidal Marsal, Francisco
    Palabras clave: Hashtag Etiqueta «#» @uroweb @residentesaeu @infoAeu
    Resumen: OBJETIVES: Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. DESIGN: Prospective multicenter cohort study. METHODS: Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ('NAE development'); from alive and NAE-experienced to death ('Death after NAE'); and from alive and NAE-free to death ('Death without NAE'). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition 'Death after NAE'. RESULTS: 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition 'Death after NAE' was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), age>50 years (1.78, 1.08-2.94), hepatitis C-coinfection (2.52, 1.38-4.61), lower CD4 cell count at cohort entry (HR 2.49; 95%CI 1.20-5.14 for CD4 cell count below 200 and HR 2.16; 95%CI 1.01-4.66 for CD4 cell count between 200-350, both compared to CD4 cell count higher than 500) and concomitant CD4<200 cells/mL (2.22, 1.42-3.44) were associated with death after NAE. CD4 count and HIV-1 RNA at engagement, previous AIDS and hepatitis C-coinfection predicted mortality in NAE-free persons. CONCLUSION: NAEs, including low-severity events, increase prominently the risk for mortality in PLWH. Prognostic factors differ between NAE-experienced and NAE-free persons. These findings should be taken into account in the clinical management of PLWH developing NAEs and may permit more targeted prevention efforts
    Áreas temáticas: Zootecnia / recursos pesqueiros Sociology Sociología Serviço social Saúde coletiva Química Psychology Psicología Planejamento urbano e regional / demografia Odontología Nutrição Multidisciplinary sciences Multidisciplinary Medicine (miscellaneous) Medicina veterinaria Medicina iii Medicina ii Medicina i Materiais Matemática / probabilidade e estatística Linguística e literatura Letras / linguística Interdisciplinary research in the social sciences Interdisciplinar Human geography and urban studies History & philosophy of science Historia Geografía Geociências General medicine General biochemistry,genetics and molecular biology General agricultural and biological sciences Farmacia Environmental studies Ensino Engenharias iv Engenharias iii Engenharias ii Engenharias i Enfermagem Educação física Educação Economia Direito Demography Comunicação e informação Ciências sociais aplicadas i Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Ciências agrárias i Ciência política e relações internacionais Ciência de alimentos Ciência da computação Biotecnología Biology Biodiversidade Biochemistry, genetics and molecular biology (miscellaneous) Astronomia / física Arquitetura, urbanismo e design Archaeology Antropologia / arqueologia Anthropology Agricultural and biological sciences (miscellaneous) Administração, ciências contábeis e turismo Administração pública e de empresas, ciências contábeis e turismo
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 19326203
    Direcció de correo del autor: francesc.vidal@urv.cat
    Identificador del autor: 0000-0002-6692-6186
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184329
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: Plos One. 12 (9): e0184329-
    Referencia de l'ítem segons les normes APA: Masiá M, Padilla S, Moreno S, Barber X, Iribarren JA, Del Romero J, Gómez-Sirvent JL, Rivero M, Vidal F, Campins AA, Gutiérrez F, Cohorte de la Red de (2017). Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach. Plos One, 12(9), e0184329-. DOI: 10.1371/journal.pone.0184329
    DOI del artículo: 10.1371/journal.pone.0184329
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2017
    Tipo de publicación: Journal Publications
  • Palabras clave:

    Agricultural and Biological Sciences (Miscellaneous),Biochemistry, Genetics and Molecular Biology (Miscellaneous),Biology,Medicine (Miscellaneous),Multidisciplinary,Multidisciplinary Sciences
    Zootecnia / recursos pesqueiros
    Sociology
    Sociología
    Serviço social
    Saúde coletiva
    Química
    Psychology
    Psicología
    Planejamento urbano e regional / demografia
    Odontología
    Nutrição
    Multidisciplinary sciences
    Multidisciplinary
    Medicine (miscellaneous)
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Materiais
    Matemática / probabilidade e estatística
    Linguística e literatura
    Letras / linguística
    Interdisciplinary research in the social sciences
    Interdisciplinar
    Human geography and urban studies
    History & philosophy of science
    Historia
    Geografía
    Geociências
    General medicine
    General biochemistry,genetics and molecular biology
    General agricultural and biological sciences
    Farmacia
    Environmental studies
    Ensino
    Engenharias iv
    Engenharias iii
    Engenharias ii
    Engenharias i
    Enfermagem
    Educação física
    Educação
    Economia
    Direito
    Demography
    Comunicação e informação
    Ciências sociais aplicadas i
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciências ambientais
    Ciências agrárias i
    Ciência política e relações internacionais
    Ciência de alimentos
    Ciência da computação
    Biotecnología
    Biology
    Biodiversidade
    Biochemistry, genetics and molecular biology (miscellaneous)
    Astronomia / física
    Arquitetura, urbanismo e design
    Archaeology
    Antropologia / arqueologia
    Anthropology
    Agricultural and biological sciences (miscellaneous)
    Administração, ciências contábeis e turismo
    Administração pública e de empresas, ciências contábeis e turismo
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