Literature DB >> 24965613

Clinical course and quality of care in ART-naïve patients newly presenting in a HIV outpatient clinic.

M Platten1, R Linnemann, T Kümmerle, N Jung, C Wyen, K Ehren, S Gravemann, D Gillor, O A Cornely, J Fischer, C Lehmann, J K Rockstroh, G Fätkenheuer, J J Vehreschild.   

Abstract

OBJECTIVES: Little data exist about the quality of care for HIV-infected subjects in Germany. We investigated the clinical course of HIV-infected subjects newly presenting in our HIV outpatient clinic.
METHODS: Antiretroviral therapy (ART)-naïve HIV-infected subjects presenting between 2007 and 2008 were followed until June 2012. Clinical data and laboratory parameters were collected prospectively and analysed retrospectively.
RESULTS: From 281 subjects included, 34 patients (12%) were lost to follow-up. 247 subjects remained, and 171 patients were followed for 1,497 days [1,121/1,726] (all data: median [interquartile range]). ART was started in 199 patients (81%) 182 days [44/849] after HIV diagnosis, and all patients were treated according to European guidelines or within clinical trials. The CD4 cell count at first presentation was 320/µL [160/500] and declined to 210/µL [100/300] at ART start. 12 months thereafter, the CD4 cell count increased to 410/µL [230/545]. The HIV RNA was suppressed below 50 copies/mL after 108 days [63/173] in 182 patients (91%). Initial ART was changed in 71 patients (36%) after 281 days [99/718], in five patients (7%) due to virological failure, in 66 patients (93%) due to other reasons, e.g. side effects or patient's request.
CONCLUSION: Two-thirds of the included patients were followed for more than 3 years, and ART was initiated in 81% of the patients leading to complete virological suppression in most patients. Compliance of physicians with treatment guidelines was high. Late presentation with a severely compromised immune function remains a problem and impairs the otherwise good prognosis of HIV infection.

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Year:  2014        PMID: 24965613     DOI: 10.1007/s15010-014-0646-9

Source DB:  PubMed          Journal:  Infection        ISSN: 0300-8126            Impact factor:   3.553


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