| Titre : | Clinical, immunological and virological evolution in patients with CD4 T-cell count above 500/mm3 : Is there a benefit to treat with highly active antiretroviral therapy (HAART) ? (2004) |
| Auteurs : | Lionel PIROTH ; Michal ABRAHAMOWICZ ; Christine BINQUET ; Marielle BUISSON ; Pascal CHAVANET ; Michel DUONG ; Michèle GRAPPIN ; Evelyne KOHLI ; Henri PORTIER ; Catherine Quantin ; Chu Dijon. Départment d'Informatique Médicale. Dijon. FRA ; Hôpital d'Enfants. Service des Maladies Infectieuses et Tropicales. FRA |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 19, n° 6, 2004) |
| Pagination : | 597-604 |
| Langues: | Anglais |
| Mots-clés : | Symptôme ; Homme ; Sida ; Virose ; Infection ; Thérapeutique ; Médicament antirétroviral ; Traitement antirétroviral ; Médicament antiviral ; Thérapeutique médicamenteuse ; Chimiothérapie ; VIH ; Rétrovirus ; Virus ; Epidémiologie ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xlrRI6. Diffusion soumise à autorisation]. To assess the clinical, immunological and virological evolution in HIV-1 infected patients with CD4 T-cell count above 500/mm3, a historical cohort of 202 untreated and 96 patients treated with HAART was longitudinally studied (median follow-up 36 months). Fourteen untreated and 2 treated patients experienced clinical progression (p=0.09). The difference between baseline CD4 T-cell count and after 3 years, was - 240/mm3 in the untreated group vs.+19/mm3 in the HAART group (p<10-3). A better immunological outcome was significantly associated with a HIV sexual contamination ? 0.01), HAART (p=0.01), high baseline CD4 T-cell count (p<10-3) and low baseline HIV viral load (p=0.01). In the HAART group, the incidence rate of antiretroviral modification due to tolerance difficulties was 0.23+/-0.36/patient year. A sustained undetectable HIV viral load was correlated with a low baseline HIV viral load (p=0.003) and to be antiretroviral naive (p<10-3). Thus, HAART provide a better immunological outcome in patients with high CD4 T-cell count. However, the CD4 decay slope after 3 years, the risk of therapeutic side-effects and the low risk of clinical progression do not support systematic treatment of those patients. |
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