Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study

Egger, Matthias; Hirschel, Bernard; Francioli, P.; Sudre, Philippe; Wirz, M.; Flepp, Markus; Rickenbach, Martin; Malinverni, Raffaele; Vernazza, Pietro; Battegay, Manuel

doi:10.1136/bmj.315.7117.1194

Cited by 562 publications

(314 citation statements)

References 27 publications

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“…These results could be of clinical relevance. The rapid recovery of the Candida-specific CD4 + T-lymphocyte proliferation is in agreement with epidemiological data showing a rapid decrease in the incidence of candidal oesophagitis after a few months of HAART treatment in patients with advanced immune dysfunction [39].…”

Section: Discussionsupporting

confidence: 89%

Highly active antiretroviral therapy restores in vitro mitogen and antigen-specific T-lymphocyte responses in HIV-1 perinatally infected children despite virological failure

Peruzzi

Azzari

Galli

et al. 2002

Clinical and Experimental Immunology

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SUMMARY To analyse the effect of highly active antiretroviral therapy (HAART) on T-lymphocyte functions we selected seven HIV-1 perinatally infected children (CDC immunological category 1 or 2) who had neither a fall in their plasma HIV-1 RNA levels nor a significant rise in CD4+ lymphocyte counts while receiving HAART. Clinical signs and symptoms were monitored monthly. Plasma viral load, CD4+, CD8+, CD19+ lymphocyte counts and in vitro T-lymphocyte proliferative responses to mitogens (anti-CD3, phytohaemoagglutinin, concanavalin A and pokeweed mitogen) and recall antigens (Candida albicans and tetanus toxoid) were tested at baseline and after 1, 3, 6 and 12 months of HAART. Twenty-two healthy age-matched children were studied as controls. A gain in body weight, no worsening of the disease and no recurrence of opportunistic infections were observed. At baseline, the majority of the children had low responses to mitogens, and all of them had a defective in vitro antigen-specific T-lymphocyte response (<2 standard deviations below the mean result for controls). During HAART, a significant increase in the response to mitogens and antigens was observed in all the patients. The T-lymphocyte response was restored more consistently against antigens to which the immune system is constantly exposed (Candida albicans, baseline versus 12 months: P < 0·001) compared with a low-exposure antigen (tetanus toxoid, baseline versus 12 months: P < 0·01). HAART restores in vitro T-lymphocyte responses even in the absence of a significant viral load decrease and despite any significant increase in CD4+ lymphocyte counts. It implies that a direct mechanism might be involved in the overall immune recovery under HAART.

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Section: Discussionsupporting

confidence: 89%

Highly active antiretroviral therapy restores in vitro mitogen and antigen-specific T-lymphocyte responses in HIV-1 perinatally infected children despite virological failure

Peruzzi

Azzari

Galli

et al. 2002

Clinical and Experimental Immunology

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“…The evidence from clinical trials thus supports the notion that better access to antiretroviral treatment and prophylaxis against opportunistic disease explain the survival differences observed in our analysis. This interpretation is also supported by the observation made in the SHCS [27] and other cohorts [28][29][30][31], that survival of study participants has in fact improved following the introduction of these interventions. The rapid introduction of new therapies and prophylactic regimens, both within and outside the framework of clinical trials, is an important objective of the SHCS.…”

Section: Discussionsupporting

confidence: 55%

Early participation in an HIV cohort study slows disease progression and improves survival

Battegay¹,

Wirz²,

Steuerwald³

et al. 1998

J Intern Med

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“…Based on theoretical considerations and anecdotal or single-centre experiences most authors and expert committees have argued that travelling to tropical countries carries substantial additional risks in HIV-infected travellers (WIL SON et al, 1991). We examined this issue in the Swiss HIV Cohort Study, a prospective study with national coverage which includes about 70% of AIDS cases diagnosed in the country (LEDERGERBER et al, 1994;EGGER et al, 1997). Over 1000 trips were recorded among the 4549 patients included in this analysis, which demonstrates that travel to tropical regions is popular among people with HIV infection.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of wasting syndrome in HIV-infected travellers: prospective multicentre study

Furrer

Chan

Weber

et al. 2001

Transactions of the Royal Society of Tropical Medicine and Hygi

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HIV-infected patients from moderate regions who travel in tropical countries may experience clinical disease progression due to exposure to bacteria (including mycobacteria), fungi and parasites. In the Swiss HIV Cohort Study we examined the hypothesis that travelling increases the risk of tuberculosis, wasting syndrome, cryptosporidiosis, isosporiasis, cryptococcosis, coccidiomycosis, histoplasmosis and Salmonella septicaemia. A total of 4549 participants were included (in 1988-98) ofwhom 596 (13' 1%) travelled at least once. During 16 800 person-years of follow-up 23 1 patients developed at least 1 of the diseases of interest. Wasting syndrome was the only diagnosis significantly associated with travelling (hazard ratio 2.16, 95% confidence interval 1.09 to 4.30). The risk ofwasting syndrome ('slim disease') should be taken into account when counselling HIV-infected patients intending to travel in tropical regions.

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Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study

Abstract: The introduction of antiretroviral combination therapies outside the selected patient groups included in clinical trials has led to comparable reductions in disease progression and mortality.

Cited by 562 publications

References 27 publications

Highly active antiretroviral therapy restores in vitro mitogen and antigen-specific T-lymphocyte responses in HIV-1 perinatally infected children despite virological failure

Highly active antiretroviral therapy restores in vitro mitogen and antigen-specific T-lymphocyte responses in HIV-1 perinatally infected children despite virological failure

Early participation in an HIV cohort study slows disease progression and improves survival

Increased risk of wasting syndrome in HIV-infected travellers: prospective multicentre study

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