OBJECTIVE: To estimate the effect of discontinuing antiretroviral therapy (ART) on survival, among women who initiated highly active antiretroviral therapy (HAART). DESIGN: A multicenter cohort study. METHODS: A total of 951 HAART-initiated women were followed for total mortality between 1995 and 2002. The relative hazard (RH) of death attributable to discontinuing all ART was estimated using an inverse probability of treatment-weighted marginal structural Cox proportional hazards model, as well as standard Cox models. RESULTS: Three hundred and forty-three out of 951 women discontinued all ART during the 3187 person-years of follow-up, and 116 died. The RH of death attributable to discontinuation was 1.97 [95% confidence interval (CI) 1.17, 3.31] from the marginal structural Cox model. A RH of 1.49 (95% CI 0.94, 2.35) was observed using the same set of covariates in a standard Cox model. CONCLUSION: An increased risk of mortality for those HAART initiators who discontinued ART was observed using a marginal structural Cox model. This increased risk was independent of measured treatment failure, and was greatly attenuated in a standard Cox model with time-varying covariates.
OBJECTIVE: To estimate the effect of discontinuing antiretroviral therapy (ART) on survival, among women who initiated highly active antiretroviral therapy (HAART). DESIGN: A multicenter cohort study. METHODS: A total of 951 HAART-initiated women were followed for total mortality between 1995 and 2002. The relative hazard (RH) of death attributable to discontinuing all ART was estimated using an inverse probability of treatment-weighted marginal structural Cox proportional hazards model, as well as standard Cox models. RESULTS: Three hundred and forty-three out of 951 women discontinued all ART during the 3187 person-years of follow-up, and 116 died. The RH of death attributable to discontinuation was 1.97 [95% confidence interval (CI) 1.17, 3.31] from the marginal structural Cox model. A RH of 1.49 (95% CI 0.94, 2.35) was observed using the same set of covariates in a standard Cox model. CONCLUSION: An increased risk of mortality for those HAART initiators who discontinued ART was observed using a marginal structural Cox model. This increased risk was independent of measured treatment failure, and was greatly attenuated in a standard Cox model with time-varying covariates.
Authors: Anne M Neilan; Brad Karalius; Kunjal Patel; Russell B Van Dyke; Mark J Abzug; Allison L Agwu; Paige L Williams; Murli Purswani; Deborah Kacanek; James M Oleske; Sandra K Burchett; Andrew Wiznia; Miriam Chernoff; George R Seage; Andrea L Ciaranello Journal: JAMA Pediatr Date: 2017-05-01 Impact factor: 16.193
Authors: Daniel Westreich; Stephen R Cole; Phyllis C Tien; Joan S Chmiel; Lawrence Kingsley; Michele Jonsson Funk; Kathryn Anastos; Lisa P Jacobson Journal: Am J Epidemiol Date: 2010-02-05 Impact factor: 4.897
Authors: John D Morris; Elizabeth T Golub; Shruti H Mehta; Lisa P Jacobson; Stephen J Gange Journal: AIDS Res Ther Date: 2007-06-06 Impact factor: 2.250
Authors: Kristina M Talbert-Slagle; Maureen E Canavan; Erika M Rogan; Leslie A Curry; Elizabeth H Bradley Journal: AIDS Date: 2016-02-20 Impact factor: 4.177