OBJECTIVE: To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV). DESIGN: Prospective cohort study of patients with AIDS, conducted from 1998 through 2003. PARTICIPANTS: One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis. METHODS: Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data. MAIN OUTCOME MEASURE: Mortality. RESULTS: The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100,000 copies/ml vs. <400 copies/ml; P<0.0001), lower CD4+ T-cell count at enrollment (RR = 3.8 for CD4+ T cell count 0-49 cells/microl vs. > or = 200 cells/microl; P<0.0001), CMV viral load > or = 400 copies/ml (RR = 1.9; P = 0.002), lower hemoglobin (RR = 1.7 for hemoglobin <10 g/dl; P = 0.009), a history of cryptococcal meningitis (RR = 1.7; P = 0.02), CMV retinitis (RR = 1.6; P = 0.0002), and Karnofsky score < or = 80 (RR = 1.4; P = 0.008). CONCLUSIONS: In the era of HAART, CMV disease as manifested by CMV retinitis and a detectable CMV viral load were associated with an increased risk for mortality, even after adjusting for demographic, treatment, immunologic, and HIV virologic factors.
OBJECTIVE: To evaluate risk factors for mortality among patients with AIDS in the era of highly active antiretroviral therapy (HAART), particularly the effect of cytomegalovirus (CMV). DESIGN: Prospective cohort study of patients with AIDS, conducted from 1998 through 2003. PARTICIPANTS: One thousand five hundred eighty-three patients with AIDS, of whom 374 had CMV retinitis. METHODS:Patients were contacted every 3 months, with examinations at least every 6 months, in which standardized data were collected on AIDS history and treatment, eye examinations, and hematologic, virologic, and immunologic laboratory data. MAIN OUTCOME MEASURE: Mortality. RESULTS: The overall mortality rate was 0.07 deaths/person-year. In a multivariate analysis, the following baseline risk factors were associated with an increased mortality: higher human immunodeficiency virus (HIV) viral load (relative risk [RR] = 4.6 for HIV viral load >100,000 copies/ml vs. <400 copies/ml; P<0.0001), lower CD4+ T-cell count at enrollment (RR = 3.8 for CD4+ T cell count 0-49 cells/microl vs. > or = 200 cells/microl; P<0.0001), CMV viral load > or = 400 copies/ml (RR = 1.9; P = 0.002), lower hemoglobin (RR = 1.7 for hemoglobin <10 g/dl; P = 0.009), a history of cryptococcal meningitis (RR = 1.7; P = 0.02), CMV retinitis (RR = 1.6; P = 0.0002), and Karnofsky score < or = 80 (RR = 1.4; P = 0.008). CONCLUSIONS: In the era of HAART, CMV disease as manifested by CMV retinitis and a detectable CMV viral load were associated with an increased risk for mortality, even after adjusting for demographic, treatment, immunologic, and HIV virologic factors.
Authors: Jens-Uwe Vogel; Jürgen Otte; Frank Koch; Hermann Gümbel; Hans Wilhelm Doerr; Jindrich Cinatl Journal: Med Microbiol Immunol Date: 2012-06-06 Impact factor: 3.402
Authors: Douglas A Jabs; Alka Ahuja; Mark Van Natta; Alice Lyon; Sunil Srivastava; Sapna Gangaputra Journal: Ophthalmology Date: 2010-07-29 Impact factor: 12.079
Authors: Douglas A Jabs; Alka Ahuja; Mark L Van Natta; Alice T Lyon; Steven Yeh; Ronald Danis Journal: Ophthalmology Date: 2015-04-17 Impact factor: 12.079
Authors: David M Naeger; Jeffrey N Martin; Elizabeth Sinclair; Peter W Hunt; David R Bangsberg; Frederick Hecht; Priscilla Hsue; Joseph M McCune; Steven G Deeks Journal: PLoS One Date: 2010-01-29 Impact factor: 3.240