Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4.
We studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4).We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). Th...
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doaj-6273b013e42746a79909035c58954db92020-11-25T02:29:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011210e018444110.1371/journal.pone.0184441Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4.Sophie GrabarHana Selinger-LenemanSophie AbgrallGilles PialouxLaurence WeissDominique CostagliolaWe studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4).We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). Those with ≥8 years of known HIV infection and a CD4 cell nadir ≥500/mm3 were classified as LTNP and those with ≥10 years of known HIV infection and 90% of plasma viral load (VL) values ≤500 copies/ml in the absence of cART as HIC. cART initiation without loss of status and death from non AIDS-defining causes were considered as competing events.After 5 years of follow-up, 33% (95%CI; 27-42) of 171 LTNP patients and 17% (95%CI; 10-30) of 72 HIC patients had lost their status. In multivariable analyses, loss of LTNP status was associated with lower baseline CD4 cell counts and CD4/CD8 ratios. Only VL was significantly associated with loss of HIC status after adjustment for the baseline CD4 cell count, the CD4/CD8 ratio, and concomitant LTNP status. The hazard ratio for loss of HIC status was 5.5 (95%CI, 1.5-20.1) for baseline VL 50-500 vs ≤50 cp/mL, after adjustment for the baseline CD4 cell count.One-third of LTNP and one-fifth of HIC patients lost their status after 5 years of follow-up, raising questions as to the possible benefits and timing of ART initiation in these populations.http://europepmc.org/articles/PMC5624574?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sophie Grabar Hana Selinger-Leneman Sophie Abgrall Gilles Pialoux Laurence Weiss Dominique Costagliola |
spellingShingle |
Sophie Grabar Hana Selinger-Leneman Sophie Abgrall Gilles Pialoux Laurence Weiss Dominique Costagliola Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. PLoS ONE |
author_facet |
Sophie Grabar Hana Selinger-Leneman Sophie Abgrall Gilles Pialoux Laurence Weiss Dominique Costagliola |
author_sort |
Sophie Grabar |
title |
Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. |
title_short |
Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. |
title_full |
Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. |
title_fullStr |
Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. |
title_full_unstemmed |
Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4. |
title_sort |
loss of long-term non-progressor and hiv controller status over time in the french hospital database on hiv - anrs co4. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
We studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4).We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). Those with ≥8 years of known HIV infection and a CD4 cell nadir ≥500/mm3 were classified as LTNP and those with ≥10 years of known HIV infection and 90% of plasma viral load (VL) values ≤500 copies/ml in the absence of cART as HIC. cART initiation without loss of status and death from non AIDS-defining causes were considered as competing events.After 5 years of follow-up, 33% (95%CI; 27-42) of 171 LTNP patients and 17% (95%CI; 10-30) of 72 HIC patients had lost their status. In multivariable analyses, loss of LTNP status was associated with lower baseline CD4 cell counts and CD4/CD8 ratios. Only VL was significantly associated with loss of HIC status after adjustment for the baseline CD4 cell count, the CD4/CD8 ratio, and concomitant LTNP status. The hazard ratio for loss of HIC status was 5.5 (95%CI, 1.5-20.1) for baseline VL 50-500 vs ≤50 cp/mL, after adjustment for the baseline CD4 cell count.One-third of LTNP and one-fifth of HIC patients lost their status after 5 years of follow-up, raising questions as to the possible benefits and timing of ART initiation in these populations. |
url |
http://europepmc.org/articles/PMC5624574?pdf=render |
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