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Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand

หน่วยงาน มหาวิทยาลัยเชียงใหม่

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ชื่อเรื่อง : Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand
นักวิจัย : Duong T. , Jourdain G. , Ngo-Giang-Huong N. , Le Coeur S. , Kantipong P. , Buranabanjasatean S. , Leenasirimakul P. , Ariyadej S. , Tansuphasawasdikul S. , Thongpaen S. , Lallemant M.
คำค้น : -
หน่วยงาน : มหาวิทยาลัยเชียงใหม่
ผู้ร่วมงาน : -
ปีพิมพ์ : 2555
อ้างอิง : 19326203 , 10.1371/journal.pone.0043375 , http://www.scopus.com/inward/record.url?eid=2-s2.0-84865054223&partnerID=40&md5=afddb7d3a31144f39de3fb73df4aa7a9 , http://cmuir.cmu.ac.th/handle/6653943832/887
ที่มา : -
ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : -
บทคัดย่อ/คำอธิบาย :

Background: Data on determinants of long-term disease progression in HIV-infected patients on antiretroviral therapy (ART) are limited in low and middle-income settings. Methods: Effects of current CD4 count, viral load and haemoglobin and diagnosis of AIDS-defining events (ADEs) after start of combination ART (cART) on death and new ADEs were assessed using Poisson regression, in patient aged ≥18 years within a multi-centre cohort in Thailand. Results: Among 1,572 patients, median follow-up from cART initiation was 4.4 (IQR 3.6-6.3) years. The analysis of death was based on 60 events during 6,573 person-years; 30/50 (60%) deaths with underlying cause ascertained were attributable to infections. Analysis of new ADE included 192 events during 5,865 person-years; TB and Pneumocystis jiroveci pneumonia were the most commonly presented first new ADE (35% and 20% of cases, respectively). In multivariable analyses, low current CD4 count after starting cART was the strongest predictor of death and of new ADE. Even at CD4 above 200 cells/mm 3, survival improved steadily with CD4, with mortality rare at ≥500 cells/mm 3 (rate 1.1 per 1,000 person-years). Haemoglobin had a strong independent effect, while viral load was weakly predictive with poorer prognosis only observed at ≥100,000 copies/ml. Mortality risk increased following diagnosis of ADEs during cART. The decline in mortality rate with duration on cART (from 21.3 per 1,000 person-years within first 6 months to 4.7 per 1,000 person-years at ≥36 months) was accounted for by current CD4 count. Conclusions: Patients with low CD4 count or haemoglobin require more intensive diagnostic and treatment of underlying causes. Maintaining CD4≥500 cells/mm 3 minimizes mortality. However, patient monitoring could potentially be relaxed at high CD4 count if resources are limited. Optimal ART monitoring strategies in low-income settings remain a research priority. Better understanding of the aetiology of anaemia in patients on ART could guide prevention and treatment. © 2012 Duong et al.

บรรณานุกรม :
Duong T. , Jourdain G. , Ngo-Giang-Huong N. , Le Coeur S. , Kantipong P. , Buranabanjasatean S. , Leenasirimakul P. , Ariyadej S. , Tansuphasawasdikul S. , Thongpaen S. , Lallemant M. . (2555). Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand.
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Duong T. , Jourdain G. , Ngo-Giang-Huong N. , Le Coeur S. , Kantipong P. , Buranabanjasatean S. , Leenasirimakul P. , Ariyadej S. , Tansuphasawasdikul S. , Thongpaen S. , Lallemant M. . 2555. "Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand".
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Duong T. , Jourdain G. , Ngo-Giang-Huong N. , Le Coeur S. , Kantipong P. , Buranabanjasatean S. , Leenasirimakul P. , Ariyadej S. , Tansuphasawasdikul S. , Thongpaen S. , Lallemant M. . "Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand."
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ , 2555. Print.
Duong T. , Jourdain G. , Ngo-Giang-Huong N. , Le Coeur S. , Kantipong P. , Buranabanjasatean S. , Leenasirimakul P. , Ariyadej S. , Tansuphasawasdikul S. , Thongpaen S. , Lallemant M. . Laboratory and clinical predictors of disease progression following initiation of combination therapy in HIV-infected adults in Thailand. เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ ; 2555.