Temporal Changes in the Rate of Progression to Death Among Italians With Known Date of HIV Seroconversion: Estimates of the Population Effect of Treatment

Dorrucci, Maria; Balducci, M; Pezzotti, Patrizio; Sinicco, Alessandro; Alberici, F.; Rezza, Giovanni

doi:10.1097/00042560-199909010-00008

Cited by 41 publications

(24 citation statements)

References 16 publications

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“…CD4 + cell counts have been studied as markers of the progression of HIV infection [2][3][4], as a measure of the relative risk of developing opportunistic infections [5], to estimate the impact of HIV and the use of antiretroviral drugs on the epidemiological progression of tuberculosis (TB) [1], and to estimate the proportion of malaria that is attributable to HIV in sub-Saharan Africa [6]. The World Health Organization (WHO) recommends antiretroviral therapy (ART) for people in WHO clinical disease stage IV, regardless of CD4 + cell count, those in stage III with CD4 + cell counts we consider the implications of this variation on the distribution of CD4 + cells within and among populations of HIVpositive people as HIV epidemics mature.…”

mentioning

confidence: 99%

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations

Williams¹,

Korenromp

Gouws

et al. 2006

J INFECT DIS

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The model provides a way to estimate the changing distribution of CD4+ cell counts and, hence, the changing incidence of HIV-related opportunistic infections as the epidemic matures. This could substantially improve the planning of health services, including the need and demand for antiretroviral therapy. Better data are needed to test the model and its assumptions more rigorously and to fully understand the variability in CD4+ cell counts within and among populations.

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confidence: 99%

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations

Williams¹,

Korenromp

Gouws

et al. 2006

J INFECT DIS

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“…In IDU, pre-AIDS deaths due to natural causes are clearly associated with more advanced HIV disease [20,22]. As both pre-AIDS death (in progression to AIDS analysis) and non-natural death (in progression to death analyses) are usually not accounted for, the effect of HAART on progression to AIDS in IDU as a group has probably been underestimated in other studies [1,3,6].…”

Section: Discussionmentioning

confidence: 99%

“…Since highly active antiretroviral therapy (HAART) became generally available, the risk of HIV disease progression has greatly decreased among injecting drug users (IDU), although not as much as in other HIV-infected groups [1][2][3][4][5][6][7]. In general, IDU are less likely to be on HAART [8,9], and are less compliant than other HIV-infected individuals [10]; in those taking [11][12][13][14] HAART, the immunological and virological responses are less pronounced in the short term [15][16][17] and in the long term [18].…”

Section: Introductionmentioning

confidence: 99%

Do HIV Disease Progression and HAART Response Vary among Injecting Drug Users in Europe?

et al. 2005

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Prior to HAART availability, there was no evidence of a geographical variation in HIV disease progression among injecting drug users (IDU) from different European regions. Nowadays, factors of importance regarding HIV disease progression in the face of HAART availability, such as HAART access, adherence, and the organization of care for IDU may differ across Europe. Therefore we studied HIV disease progression in a European study of IDU with known dates of HIV-seroconversion. Results show that with ongoing HAART availability, the risk of HIV disease progression has continued to decrease. When accounting for pre-AIDS death (in AIDS analyses) and non-natural deaths (suicide, overdose, accidents and homicide, in analyses of death) which are common among IDU, the risk of AIDS and death has decreased by as much as 65% and 75%, respectively, in 2000/2001. Results show little geographic variation in progression to AIDS. All-cause mortality was higher in IDU from Glasgow than elsewhere, while in the Valencian region (Spain) IDU were at a significantly lower risk of non-natural deaths. The timing of HAART initiation by treatment-naïve IDU likewise differed across Europe: IDU in Amsterdam, Innsbruck, and Edinburgh started at significantly lower CD4 counts than IDU in Paris, Geneva, Glasgow, and the Valencian region, but the subsequent short-term immune response was similar. In conclusion, the risk in progression to AIDS or natural death is similar across western Europe although IDU across Europe differ in other factors, such as the risk of non-natural death and the timing of HAART initiation.

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“…study collects prospective data coming from over 70 clinical centers in Italy that follow about 65% of the known HIV-positive population [13]. As already detailed in previous analyses, carried out in this [14] and other Italian studies [6,[15][16][17], the diffusion from 1996 of antiretroviral combination therapies with three or more drugs (HAART) led to a marked decrease in mortality and incidence of AIDS cases.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of HIV treatments: The I.CO.N.A. cohort study

et al. 2005

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Objective: To describe the changes in costs of care for HIV-positive patients in Italy after the spread of antiretroviral combination therapies (HAART). Methods: Five thousand four hundred and twenty-two patients from the I.CO.N.A. (Italian Cohort Naive Antiretrovirals) study were followed between 1997 and 2002. Costs included antiretroviral therapies (ART), hospital admissions, prophylaxis, and main laboratory examinations. The perspective was that of the National Health Service. M. Merito et al. / Health Policy 74 (2005) 304-313 305 Conclusions: From 1997 to 2002 inpatient costs progressively decreased in favor of antiretroviral therapy. Annual average costs per patient decreased, while total direct costs increased over time: health resources, initially concentrated on hospitalized patients were then distributed over a growing number of subjects.

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Temporal Changes in the Rate of Progression to Death Among Italians With Known Date of HIV Seroconversion: Estimates of the Population Effect of Treatment

Abstract: A reduction in the risk of death, probably due to combination antiretroviral therapy, was observed in 1997 after having adjusted for age at SC and year of SC.

Cited by 41 publications

References 16 publications

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations

Do HIV Disease Progression and HAART Response Vary among Injecting Drug Users in Europe?

Economic evaluation of HIV treatments: The I.CO.N.A. cohort study

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Temporal Changes in the Rate of Progression to Death Among Italians With Known Date of HIV Seroconversion: Estimates of the Population Effect of Treatment

Abstract: A reduction in the risk of death, probably due to combination antiretroviral therapy, was observed in 1997 after having adjusted for age at SC and year of SC.

Cited by 41 publications

References 16 publications

HIV Infection, Antiretroviral Therapy, and CD4+Cell Count Distributions in African Populations

HIV Infection, Antiretroviral Therapy, and CD4+Cell Count Distributions in African Populations

Do HIV Disease Progression and HAART Response Vary among Injecting Drug Users in Europe?

Economic evaluation of HIV treatments: The I.CO.N.A. cohort study

Contact Info

Product

Resources

About

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations

HIV Infection, Antiretroviral Therapy, and CD4⁺Cell Count Distributions in African Populations