| Titre : | Modeling changes in CD4-positive T-lymphocyte counts after the start of highly active antiretroviral therapy and the relation with risk of opportunistic infections : The aquitaine cohort, 1996-1997. (2001) |
| Auteurs : | C. BINQUET ; G. CHENE ; Francois Dabis ; H. JACQMIN-GADDA ; V. JOURNOT ; D. LACOSTE ; M. SAVES ; Groupe d'Epidémiologie Clinique du Sida en Aquitaine. INC ; Institut National de la Santé et de la Recherche Médicale. (I.N.S.E.R.M.). Unité 330. Bordeaux. FRA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 153, n° 4, 2001) |
| Pagination : | 386-393 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; Homme ; Thérapeutique ; Thérapeutique médicamenteuse ; Médicament antiviral ; Epidémiologie ; Facteur risque ; Complication ; Système immunitaire ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST R0xAlfqv. Diffusion soumise à autorisation]. After initiation of a treatment for human immunodeficiency virus type 1 infection containing a protease inhibitor, immune restoration associated with increases in CD4-positive (CD4+) T lymphocyte count may be delayed. In a sample of patients who had been prescribed protease inhibitors for the first time, the authors tested to see whether there was a minimal duration of CD4+cell count increase before the increase had an impact on the occurrence of opportunistic infections. The evolution (difference between time t and baseline) of CD4+cell count was modeled using a mixed effects linear model. Changes in CD4+count estimated by this model were then included as time-dependent covariates in a proportional hazards model. Finally, the authors tested for the existence of a CD4+change x time interaction. The authors used a sample of 553 French patients first prescribed protease inhibitors in 1996 and followed for a median of 16 months. During the first 120 days, there was no association between CD4+change and the rate of opportunistic infections. After 120 days, each 50-cell/mm3 increase in CD4+count was associated with a 60% (95% confidence interval : 45,72) reduction in the incidence of opportunistic infections. These results, based on modeling of CD4+cell response, at least indirectly reinforce the concept of a delayed but possible immune recovery with the use of protease inhibitors. (...) |
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