Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres

Mouton, Y; Alfandari, S.; Valette, M.; Cartier, F; Dellamonica, P.; Humbert, G.; Lang, Jean; Massip, Patrice; Mechali, D.; Leclercq, Pascale; Modaï, J; Portier, H.

doi:10.1097/00002030-199712000-00003

Cited by 336 publications

(108 citation statements)

References 2 publications

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“…[1][2][3][4][5] Unfortunately, virologic rebound commonly occurs in treatmentnaive and treatment-experienced patients.6 -8 Persistent viral replication in the setting of drug selection can lead to the appearance of amino acid substitutions that confer resistance to the current regimen. Thus, identification of patients with acquired drug resistance mutations is critical to achieve virologic suppression and improve patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Genotypic Susceptibility Scores and HIV Type 1 RNA Responses in Treatment-Experienced Subjects with HIV Type 1 Infection

Anderson

Jiang

Ding

et al. 2008

AIDS Research and Human Retroviruses

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This study compared the role of genotypic susceptibility scores (GSS) as a predictor of virologic response in a group (n = 234) of HIV-infected, protease inhibitor (PI)-experienced subjects. Two scoring methods [discrete genotypic susceptibility score (dGSS) and continuous genotypic susceptibility score (cGSS)] were developed. Each drug in the subject's regimen was given a binary susceptibility score using Stanford inferred drug resistance scores to calculate the dGSS. In contrast to the dGSS, the cGSS model was designed to reflect partial susceptibility to a drug. Both GSS were independent predictors of week 16 virologic response. We also compared the GSS to a phenotypic susceptibility score (PSS) model on a subset of subjects that had both GSS and PSS performed, and found that both models were predictive of virologic response. Genotypic analyses at enrollment showed that subjects who were virologic nonresponders at week 16 revealed enrichment of several mutated codons associated with nucleoside reverse transcriptase inhibitors (NRTI) (codons 67, 69, 70, 118, 215, and 219) or PI resistance (codons 10, 24, 71, 73, and 88) compared to subjects who were virologic responders. Regression analyses revealed that protease mutations at codons 24 and 90 were most predictive of poor virologic response, whereas mutations at 82 were associated with enhanced virologic response. Certain NNRTI-associated mutations, such as K103N, were rapidly selected in the absence of NRTIs. These data indicate that GSS may be a useful tool in selecting drug regimens in HIV-1-infected subjects to maximize virologic response and improve treatment outcomes.

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Section: Introductionmentioning

confidence: 99%

Genotypic Susceptibility Scores and HIV Type 1 RNA Responses in Treatment-Experienced Subjects with HIV Type 1 Infection

Anderson

Jiang

Ding

et al. 2008

AIDS Research and Human Retroviruses

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“…Contrary to what has been reported for NBP in non-HIV-positive immunocompromised patients, the incidence of NBP (and of other infections) has decreased in patients with AIDS receiving HAART in recent in years. In fact, HAART has been shown not only to have a powerful effect on HIV, as shown by the reduction in plasma HIV ribonucleic acid (RNA) and the increase in peripheral T CD4+ cells, but also to reduce the incidence of opportunistic infections (including AIDS-related CNS diseases) and death [12].…”

Section: Discussionmentioning

confidence: 99%

“…In human immunode®ciency virus (HIV)-infected subjects, bacterial pneumonia is responsible for signi®cant morbidity [6±8] and, although most episodes are community-acquired, nosocomial episodes are also not infrequently observed [9±11]. It is also noted that, although the incidence of nosocomial bacterial pneumonia (NBP), as well as other opportunistic infections [12] has decreased considerably in the era of highly active antiretroviral therapy (HAART), NBP still represents an important cause of mortality [13]. However, to the best of the authors9 knowledge, few reports have focused on NBP in such patients.…”

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confidence: 99%

Nosocomial bacterial pneumonia in human immunodeficiency virus infected subjects: incidence, risk factors and outcome

et al. 2001

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The presented study examined the incidence, risk factors and outcome of nosocomial bacterial pneumonia (NBP) in human immunodeficiency virus (HIV)-infected subjects. Forty-two cases of NBP were ascertained by a 5-yr prospective surveillance and were matched to 84 controls. NBP incidence was 10.8 per 10,000 hospital patient-days. In particular, the incidence of NBP was 13.9 per 10,000 patient-days in the period 1994–1996 and 5.6 per 10,000 patient-days in the period 1997–1998 (p=0.01).By using regression analysis, predictors for developing NBP were an increasing value of Acute Physiology and Chronic Health Evaluation (APACHE) III score (p<0.01) and the presence of acquired immune deficiency syndrome (AIDS)-related central nervous system (CNS) diseases (p=0.01). The additional hospital stay attributable to NBP was 15 days. The attributable mortality rate was estimated to be 29%.Nosocomial bacterial pneumonia is more common in patients with advanced human immunodeficiency virus infection, high Acute Physiology and Chronic Health Evaluation III score and central nervous system diseases. Although the incidence of nosocomial bacterial pneumonia, as well of other opportunistic infections, decreased considerably in the era of highly active antiretroviral therapy, it still represents an important cause of mortality.

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“…Their theoretical efficacy in reducing the incidence of new AIDS cases and associated mortality, shown in controlled clinical studies [1,2], has since been confirmed in the population [3][4][5][6]. As a consequence, there has been a change in the use of health resources for HIV positive patients from inpatient to outpatient care, and from the use of drugs to treat opportunistic infections to antiviral medications [7][8][9].…”

Section: Introductionmentioning

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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Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres

Abstract: This study supports the extensive use of HAART in HIV-infected patients.

Cited by 336 publications

References 2 publications

Genotypic Susceptibility Scores and HIV Type 1 RNA Responses in Treatment-Experienced Subjects with HIV Type 1 Infection

Genotypic Susceptibility Scores and HIV Type 1 RNA Responses in Treatment-Experienced Subjects with HIV Type 1 Infection

Nosocomial bacterial pneumonia in human immunodeficiency virus infected subjects: incidence, risk factors and outcome

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

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