This study provides an estimate of the proportion of HIV-positive patients in Italian clinics showing
an adverse prognosis (defined as a CD4 count 200 cells/mL or an HIV RNA 450 HIV-1 RNA
copies/mL) over time, and investigates whether this proportion varied according to patients
We estimated the annual proportion of patients with a CD4 count 200 cells/mL or HIV RNA
450 copies/mL out of the total number of patients in the Icona Foundation cohort seen in any given
year, both overall and after stratifying by demographical and treatment status groups. Generalized
estimating equation models for Poisson regression were applied.
In 1998 2008, the prevalence of patients with a CD4 count 200 cells/mL decreased from 14 to 6%
[adjusted relative risk (RR) 0.86/year; 95% confidence interval (CI) 0.84 0.88; Po0.0001]. The
prevalence of HIV RNA 450 copies/mL decreased from 66 to 40% (adjusted RR 0.95/year; 95% CI
0.95 0.96; Po0.0001) in all patients and from 38 to 12% in the subgroup of patients who had
previously received antiretroviral therapy (ART) for 6 months (adjusted RR 0.89/year; 95% CI
0.88 0.90; Po0.0001).
There was a substantial increase in the success rate of ART in Italy in 1998 2008, resulting in a
lower percentage of patients with adverse prognosis in recent years. The use of ART seemed to be the
most important determinant of viral load outcome, regardless of mode of transmission. Although
injecting drug users showed a less marked improvement in CD4 cell count over time than other risk
groups, they showed a similar improvement in detectable viral load.
|Numero di pagine||9|
|Stato di pubblicazione||Pubblicato - 2011|
- immunological response rates