Predictores de progresión y muerte en pacientes con infección avanzada por el VIH en la era de los tratamientos antirretrovirales de gran actividad

Ongoing burden of disease and mortality from HIV/CMV coinfection in Africa in the antiretroviral therapy era

“…In studies conducted in developed countries, detectable CMV DNA in plasma (Wohl et al, 2005 ) or in whole blood (Deayton et al, 2004 ; Reus et al, 2004 ) have been shown to be independent predictors of death even after adjusting for HIV RNA level or CD4+ T cell count. Strikingly, a recent study of HIV-positive adults in rural Tanzania that used dried blood spots to detect CMV viraemia found a hazard ratio of 5 for mortality in the presence of CMV (Brantsæter et al, 2012 ).…”

Efficacy and safety of preemptive therapy for cytomegalovirus end-organ disease in people living with HIV: a systematic review and meta-analysis

“…Several studies have shown that the presence of CMV viremia may be an independent predictor of mortality, even after adjusting for HIV viral load level or CD4 cell count. 21 , 22 , 23 Despite this, the studies included in the present review did not demonstrate significant differences between preemptive therapy and placebo or non-treatment for the outcome of all-cause mortality, suggesting that other factors different to CMV infection might be responsible for the fatal outcome. Similarly, observational studies have not demonstrated a favorable effect of preemptive therapy for mortality, most of them with small sample sizes and methodological limitations due to their retrospective nature.…”

Evolución de los parámetros clínicos en reclusos en tratamiento antirretroviral

“…El estudio de la evolución de la carga viral y el recuento de linfocitos CD4 tiene especial interés ya que varios trabajos han concluido que son estos marcadores clínicos los mejores predictores al estado definitorio de SIDA o muerte 4,7 . Sin embargo, muchos de estos estudios presentan la limitación de no controlar la adherencia a la medicación antirretroviral.…”