Viremia copy-years as a predictive marker of all-cause mortality in HIV-1-infected patients initiating a protease inhibitor-containing antiretroviral treatment.

Abstract

BACKGROUND:

Viremia copy-years (VCY) has been reported as a short-term predictor of mortality. We evaluated the association of this parameter with 10-year outcome within the APROCO-COPILOTE cohort.

METHODS:

Prospective data from 1281 HIV-1-infected patients who started a first protease inhibitor-containing regimen in 1997-1999 were analyzed. Patients with baseline plasma viral load (pVL) > 500 copies per milliliter and at least 2 pVL measures from the eighth month of follow-up were selected. VCY was calculated individually over the follow-up as the area under the pVL curve. Multivariate Cox models analyzed the relation between all-cause mortality and the following variables: age, sex, geographical origin, transmission group, HIV infection duration, ART-naive, pVL at baseline, time-dependent CD4 count, and VCY.

RESULTS:

Nine hundred seventy-nine patients were followed up for a median of 10 years (interquartile range: 5-11.5). At baseline, median (interquartile range) values for duration of HIV infection, pVL, and CD4 cell count were 43 (4-95) months, 4.6 (3.9-5.2) log10 copies per milliliter, and 278 (125-416) cells per cubic millimeter, respectively. At censoring date, 77 patients (8%) had died. VCY >1.4 log10 copies × yrs/mL was an independent predictor of death (hazard ratio: 2.0; 95% confidence interval: 1.2 to 3.5), which was no longer the case after adjustment for the latest pVL value [risk ratio (RR): 1.2 for 1 additional log10 copies per milliliter; 95% confidence interval: 1.1 to 1.4].

CONCLUSIONS:

VCY was associated with mortality in HIV-infected patients under combined antiretroviral therapy but did not overweigh the predictive value of the latest pVL. VCY might be more useful as a marker of persistent viral replication than for routine clinical care.

• Authors: Catherine Chirouze, Valérie Journot, Vincent Le Moing, François Raffi, Lionel Piroth, Sandrine Reigadas, Jill-Patrice Cassuto, Geneviève Chêne, Catherine Leport, Bruno Hoen, ANRS CO 08 Aproco-Copilote Study Group
• Journal: Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 68 Issue 2 Pg. 204-8 (Feb 01 2015) ISSN: 1944-7884 [Electronic] United States
• PMID: 25590273 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Retroviral Agents
• HIV Protease Inhibitors

Topics

• Adult
• Anti-Retroviral Agents (therapeutic use)
• CD4 Lymphocyte Count
• Cohort Studies
• Demography
• Female
• HIV Infections (drug therapy, mortality, virology)
• HIV Protease Inhibitors (therapeutic use)
• HIV-1 (isolation & purification)
• Humans
• Male
• Plasma (virology)
• Prognosis
• Prospective Studies
• Survival Analysis
• Viral Load
• Viremia