Titre :
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Influence of age at infection on human immunodeficiency virus disease progression to different clinical endpoints : The SEROCO cohort (1988-1994). (1997)
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Auteurs :
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F. BELANGER ;
N. CARRE ;
A. COUTELLIER ;
C. DEVEAU ;
L. Meyer ;
Seroco Study Group. INC ;
Unité Inserm U-292 & Service d'épidémiologie. Hôpital du Kremlin-Bicêtre. Le Kremlin Bicêtre. FRA
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 26, n° 6, 1997)
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Pagination :
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1340-1345
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Langues:
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Anglais
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Mots-clés :
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Sida
;
Virose
;
Infection
;
Evolution
;
Lymphocyte
;
Epidémiologie
;
Homme
;
Facteur risque
;
Age
;
Immunopathologie
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Résumé :
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[BDSP. Notice produite par INIST nH9R0x8J. Diffusion soumise à autorisation]. Method. The influence of age at infection on progression of human immunodeficiency virus (HIV) disease to different clinical endpoints was studied among 393 HIV-seropositive adults selected from the French SEROCO cohort ; follow-up lasted from January 1988 to November 1994. Selected patients had a known date of infection and were enrolled shortly after seroconversion. Age-associated risk ratios (RR) were estimated using the Cox model (age fitted as a continuous variable and RR expressed for each 10-year increment after adjustment for symptomatic primary infection and sexual preference). Results. Age had a weak influence on progression from the date of infection to the first category B event (crude RR=1.15 ; adjusted RR=1.09 ; 95% confidence interval [Cl] : 0.89-1.36) but a marked influence on progression from the first category B to the first category C event (crude RR=1.95 ; adjusted RR=1.97 ; 95% Cl : 1.37-2.79). Similar results were obtained after adjustment for the CD4+cell count at enrolment. A qualitative CD4+cell defect could explain the influence of age, but this remains to be confirmed. Conclusion. Age at infection should be included in the definition of CD4+cell count thresholds for clinical management and treatment initiation. Risk factors for progression should be assessed according to the different clinical endpoints.
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