Factors associated with mortality among persistently viraemic triple-antiretroviral-class-experienced patients receiving antiretroviral therapy in the HIV Outpatient Study (HOPS)

Identifying factors associated with mortality for HIV-infected patients with persistent viraemia despite antiretroviral (ARV) therapy may inform diagnostic and treatment strategies. We analysed data from viraemic triple-ARV-class-experienced HIV Outpatient Study patients seen during 1 January 1999 t...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2014-10, Vol.69 (10), p.2826-2834
Main Authors: Palella, Jr, Frank J, Armon, Carl, Buchacz, Kate, Chmiel, Joan S, Novak, Richard M, D'Aquila, Richard T, Brooks, John T
Format: Article
Language:English
Subjects:
Adult
Anti-HIV Agents - administration & dosage
Antiretroviral drugs
Antiretroviral Therapy, Highly Active
Drug resistance
Drug Resistance, Viral - genetics
Drug therapy
Female
Genotype
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - mortality
HIV Infections - virology
HIV-1 - drug effects
HIV-1 - genetics
Human immunodeficiency virus
Humans
Male
Middle Aged
Mortality
Prospective Studies
Retreatment
Risk Factors
Treatment Failure
Treatment Outcome
Viral Load
Viremia
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Summary:Identifying factors associated with mortality for HIV-infected patients with persistent viraemia despite antiretroviral (ARV) therapy may inform diagnostic and treatment strategies. We analysed data from viraemic triple-ARV-class-experienced HIV Outpatient Study patients seen during 1 January 1999 to 31 December 2012 who, despite treatment that included ARVs from three major drug classes [nucleoside analogue reverse transcriptase inhibitors, non-nucleoside analogue reverse transcriptase inhibitors and protease inhibitors (PIs)], had plasma HIV RNA levels [viral load (VL)] >1000 copies/mL ['triple ARV class failure' (TCF)]. The baseline was defined as the date of meeting the TCF criteria during 1999-2008. We identified factors associated with mortality using Cox regression. Of 597 patients who met the TCF criteria (median follow-up after baseline 4.9 years), 115 (19.3%) died. Baseline factors associated with mortality were age per 10 years [hazard ratio (HR) 1.61, 95% CI 1.28-2.02], risk of HIV from use of injection drugs (HR 1.81, 95% CI 1.10-2.98), CD4+ T cell count
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dku190