ObjectiveTo estimate the rate of combination antiretroviral treatment change and factors associated with combination antiretroviral treatment change among patients recruited in the Australian HIV Observational Database (AHOD).
MethodsAnalyses were based on patients in the AHOD who had commenced combination antiretroviral treatment after 1 January 1997. Combination antiretroviral treatment change was de®ned as the addition or change of at least one antiretroviral drug. A random-effect Poisson regression model was used to assess factors associated with increased rates of combination antiretroviral treatment change.
ResultsA total of 596 patients in the AHOD were included in the analysis, with a median follow-up of 2.3 years. The overall rate of antiretroviral treatment change in this group was 0.45 combinations per year. In a multivariate analysis, a low CD4 count (, 200 cells/mL) at baseline was associated with an increased rate of treatment change [rate ratio (RR) 1.43; 95% con®dence interval (CI), 1.13, 1.80; P 0.003)]. Combinations including a nonnucleoside reverse transcriptase inhibitor were also associated with slower rates of change than treatment combinations including a protease inhibitor (RR 0.64, 95% CI, 0.51, 0.80, P , 0.001).
ConclusionInitiating combination antiretroviral at a CD4 cell count , 200 cells/mL may be associated with poorer patient outcomes. However, the possibility that clinician or patient concerns about low immunological status led to faster rates of treatment change in this group cannot be discounted.
Emotional stimuli are typically prioritized in competition for attention in healthy individuals. In contrast, there is evidence that individuals high in psychopathic traits fail to similarly prioritize emotional stimuli. With aberrant attention to emotional stimuli implicated in the development and maintenance of other psychopathologies, attentional insensitivity to emotional stimuli may also be important in the callous-unemotional responding seen in psychopathy. This study assessed emotional attention in association with psychopathic traits in a community sample (N = 121) using two commonly used emotional attention tasks—the dot probe and emotion-induced blindness tasks. Psychopathic personality traits were examined in association with two attention domains where emotional attention effects are reliably found: early perceptual competition and competition for spatial attention. Participants high in interpersonal-affective traits of psychopathy (boldness or meanness) exhibited emotional attention deficits in both domains when impulsive-antisocial traits were also high. These findings are discussed in the context of the inconsistent literature on attention to emotional stimuli in psychopathy.
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