2026-06-14T03:29:45Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/87302025-05-27T10:53:42Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608
Repisalud
author
Lodi, Sara
author
Phillips, Andrew
author
Fidler, Sarah
author
Hawkins, David
author
Gilson, Richard
author
McLean, Ken
author
Fisher, Martin
author
Post, Frank
author
Johnson, Anne M
author
Walker-Nthenda, Louise
author
Dunn, David
author
Porter, Kholoud
funder
Medical Research Council (Reino Unido)
2019-12-02T13:14:25Z
2019-12-02T13:14:25Z
2013
PLoS One. 2013 Sep 24;8(9):e75608.
10.1371/journal.pone.0075608
1932-6203
1932-6203
PloS one
24086588
http://hdl.handle.net/20.500.12105/8730
BACKGROUND: The development of HIV drug resistance and subsequent virological failure are often cited as potential disadvantages of early cART initiation. However, their long-term probability is not known, and neither is the role of duration of infection at the time of initiation. METHODS: Patients enrolled in the UK Register of HIV seroconverters were followed-up from cART initiation to last HIV-RNA measurement. Through survival analysis we examined predictors of virologic failure (2HIV-RNA ≥400 c/l while on cART) including CD4 count and HIV duration at initiation. We also estimated the cumulative probabilities of failure and drug resistance (from the available HIV nucleotide sequences) for early initiators (cART within 12 months of seroconversion). RESULTS: Of 1075 starting cART at a median (IQR) CD4 count 272 (190,370) cells/mm(3) and HIV duration 3 (1,6) years, virological failure occurred in 163 (15%). Higher CD4 count at initiation, but not HIV infection duration at cART initiation, was independently associated with lower risk of failure (p=0.033 and 0.592 respectively). Among 230 patients initiating cART early, 97 (42%) discontinued it after a median of 7 months; cumulative probabilities of resistance and failure by 8 years were 7% (95% CI 4,11) and 19% (13,25), respectively. CONCLUSION: Although the rate of discontinuation of early cART in our cohort was high, the long-term rate of virological failure was low. Our data do not support early cART initiation being associated with increased risk of failure and drug resistance.
eng
Role of HIV infection duration and CD4 cell level at initiation of combination anti-retroviral therapy on risk of failure
research article
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https://repisalud.isciii.es/bitstreams/4e26854e-2f07-4209-91ad-cdfa8c48f8e9/download
File
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application/pdf
RoleOfHIVInfection_2013.pdf
URL
https://repisalud.isciii.es/bitstreams/a752a448-ef20-45ea-967b-b1548de0e324/download
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RoleOfHIVInfection_2013.pdf.txt