https://scholars.lib.ntu.edu.tw/handle/123456789/535197
標題: | Impact of initiation of combination antiretroviral therapy according to the WHO recommendations on the survival of HIV-positive patients in Taiwan | 作者: | WANG-DA LIU Tsai W.-C. Hsu W.-T. Shih M.-C. Chen M.-Y. HSIN-YUN SUN SZU-MIN HSIEH WANG-HUEI SHENG YU-CHUNG CHUANG ARISTINE CHENG KUAN-YIN LIN YU-SHAN HUANG Huang S.-H. YI-CHIA HUANG Chen G.-J. Wu P.-Y. CHIEN-CHING HUNG SHAN-CHWEN CHANG |
公開日期: | 2020 | 出版社: | Elsevier Ltd | 卷: | 53 | 期: | 6 | 起(迄)頁: | 936-945 | 來源出版物: | Journal of Microbiology, Immunology and Infection | 摘要: | Background/purpose: Early initiation of antiretroviral therapy (ART) reduces the risks for serious infections and mortality. We aimed to assess the outcomes of initiating ART among HIV-positive Taiwanese according to the CD4 cut-off values by the WHO recommendations. Methods: We reviewed medical records of patients with newly diagnosed HIV infection between 2004 and 2015 and 3 groups of patients were defined according to the timing of ART initiation based on CD4 count recommended by WHO: Group 1 between 2004 and 2009; Group 2 between 2010 and 2012; and Group 3 between 2013 and 2015. The primary outcome was all-cause mortality. All patients were followed until 2 years after the last patient was included in each group. Results: Of 2022 patients included, the mortality rate was 18.28, 14.01, and 9.10 deaths per 1000 person-years of follow-up (PYFU) in Groups 1, 2, and 3, respectively. In multivariable Cox regression analysis, factors associated with mortality were age (per 1-year increase, adjusted hazard ratio [AHR], 1.06; 95% CI, 1.05–1.08), presence of AIDS-defining disease at HIV diagnosis (AHR, 4.81; 95% CI, 2.99–7.74), solid-organ malignancy (AHR, 3.10; 95% CI, 1.86–5.18), and initiation of ART (AHR, 0.09; 95% CI, 0.05–0.16). By competing risk regression model for non-AIDS-related death, the AHR for Group 3 versus Group 1 was 0.27 (95% CI, 0.09–0.80). Conclusions: While continued efforts are needed to improve early diagnosis and linkage to care, initiation of cART improved survival among HIV-positive patients in Taiwan according to the increasing CD4 cut-off values that were recommended by the WHO. ? 2019 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065610111&doi=10.1016%2fj.jmii.2019.03.008&partnerID=40&md5=9dd5181df35c6486d279cd27486bcc77 https://scholars.lib.ntu.edu.tw/handle/123456789/535197 |
ISSN: | 1684-1182 | DOI: | 10.1016/j.jmii.2019.03.008 | SDG/關鍵字: | abacavir; CD4 antigen; dolutegravir; efavirenz; emtricitabine; Human immunodeficiency virus proteinase inhibitor; integrase inhibitor; lamivudine; nonnucleoside reverse transcriptase inhibitor; rilpivirine; tenofovir disoproxil; anti human immunodeficiency virus agent; adolescent; adult; all cause mortality; antiretroviral therapy; Article; atypical mycobacteriosis; CD4 lymphocyte count; cerebral toxoplasmosis; clinical outcome; cohort analysis; combination drug therapy; cytomegalovirus infection; esophagus candidiasis; female; follow up; hepatitis B; hepatitis C; heterosexuality; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; injection drug user; isosporiasis; major clinical study; male; medical record review; men who have sex with men; mixed infection; nonhuman; observational study; opportunistic infection; Pneumocystis pneumonia; practice guideline; progressive multifocal leukoencephalopathy; retrospective study; solid malignant neoplasm; survival; Taiwan; Taiwanese; thrush; tuberculosis; virus load; virus transmission; World Health Organization; early diagnosis; highly active antiretroviral therapy; Human immunodeficiency virus infection; mortality; risk; survival rate; time to treatment; treatment outcome; World Health Organization; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Early Diagnosis; Female; HIV Infections; Humans; Male; Retrospective Studies; Risk; Survival Rate; Taiwan; Time-to-Treatment; Treatment Outcome; World Health Organization |
顯示於: | 醫學系 |
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