When to initiate combined antiretroviral therapy to reduce the mortality of HIV-infected individuals (Record no. 75751)

MARC details
000 -LEADER
fixed length control field 05919cam a2200457 4500
001 - CONTROL NUMBER
control field NMDX6586
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 120401t2011 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 00034819
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Cain, L.E.
240 ## - UNIFORM TITLE
Uniform title <a href="Annals of internal medicine.">Annals of internal medicine.</a>
245 ## - TITLE STATEMENT
Title When to initiate combined antiretroviral therapy to reduce the mortality of HIV-infected individuals
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc. 2011
500 ## - GENERAL NOTE
General note NMUH Staff Publications
500 ## - GENERAL NOTE
General note 154
520 ## - SUMMARY, ETC.
Summary, etc. &lt;h3&gt;&lt;span style="font-size: 8pt;"&gt;BACKGROUND &lt;span style="font-weight: normal;"&gt;:&lt;/span&gt; &lt;span style="font-weight: normal;"&gt;Most clinical guidelines recommend that AIDS-free,&lt;span class="apple-converted-space"&gt;&amp;nbsp;&lt;/span&gt;&lt;span class="highlight"&gt;HIV&lt;/span&gt;-infected personswith CD4 cell counts below 0.350 × 10(9) cells/L initiate combined&lt;span class="apple-converted-space"&gt;&amp;nbsp;&lt;/span&gt;&lt;span class="highlight"&gt;antiretroviral&lt;/span&gt;&lt;span class="apple-converted-space"&gt;&amp;nbsp;&lt;/span&gt;therapy(cART), but &lt;/span&gt;&lt;span style="font-weight: normal;"&gt;the optimalCD4 cell count at which cART should be initiated remains a matter of debate.&lt;/span&gt;&lt;/span&gt;&lt;/h3&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;OBJECTIVE &lt;span style="font-weight: normal;"&gt;: &lt;/span&gt;&lt;span style="font-weight: normal;"&gt;To identify the optimal CD4 cell count at which cART should be initiated.&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;DESIGN &lt;span style="font-weight:normal;&amp;#xA;mso-bidi-font-weight:bold"&gt;: Prospective observational data from the&lt;/span&gt;&lt;span class="apple-converted-space"&gt;&lt;span style="font-weight: normal;"&gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;span class="highlight"&gt;&lt;span style="font-weight: normal;"&gt;HIV&lt;/span&gt;&lt;/span&gt;&lt;span style="font-weight:normal;mso-bidi-font-weight:bold"&gt;-CAUSAL Collaboration anddynamic marginal structural models were used to compare cART initiationstrategies for CD4 thresholds between 0.200 and 0.500 × 10(9) cells/L.&lt;/span&gt;&lt;span style="font-weight: normal;"&gt;&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;SETTING&lt;span style="font-weight:normal;&amp;#xA;mso-bidi-font-weight:bold"&gt; : &lt;/span&gt;&lt;span class="highlight"&gt;&lt;span style="font-weight: normal;"&gt;HIV&lt;/span&gt;&lt;/span&gt;&lt;span class="apple-converted-space"&gt;&lt;span style="font-weight: normal;"&gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;span style="font-weight:normal;&amp;#xA;mso-bidi-font-weight:bold"&gt;clinics in Europe and the Veterans HealthAdministration system in the United States.&lt;/span&gt;&lt;span style="font-weight: normal;"&gt;&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;PATIENTS&lt;span style="font-weight:&amp;#xA;normal;mso-bidi-font-weight:bold"&gt; : 20, 971&lt;/span&gt;&lt;span class="apple-converted-space"&gt;&lt;span style="font-weight: normal;"&gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;span class="highlight"&gt;&lt;span style="font-weight: normal;"&gt;HIV&lt;/span&gt;&lt;/span&gt;&lt;span style="font-weight:normal;mso-bidi-font-weight:bold"&gt;-infected, therapy-naivepersons with baseline CD4 cell counts at or above 0.500 × 10(9) cells/L and noprevious AIDS-defining illnesses, of whom &lt;/span&gt;&lt;span style="font-weight: normal;"&gt;8392 had a CD4cell count that decreased into the range of 0.200 to 0.499 × 10(9) cells/L andwere included in the analysis.&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;MEASUREMENT&lt;span style="font-weight: normal;"&gt;S&lt;/span&gt;&lt;span style="font-weight:normal;mso-bidi-font-weight:bold"&gt; : Hazard ratios andsurvival proportions for all-cause mortality and a combined end point ofAIDS-defining illness or death.&lt;/span&gt;&lt;span style="font-weight: normal;"&gt;&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;RESULTS &lt;span style="font-weight:&amp;#xA;normal;mso-bidi-font-weight:bold"&gt;: Compared with initiating cART at the CD4cell count threshold of 0.500 × 10(9) cells/L, the mortality hazard ratio was1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48)for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the &lt;/span&gt;&lt;span style="font-weight: normal;"&gt;combinedend point of AIDS-defining illness or death. Limitations: CD4 cell count at cARTinitiation was not randomized. Residual confounding may exist.&lt;/span&gt;&lt;/span&gt;&lt;/h4&gt;&lt;h4&gt;&lt;span style="font-size: 8pt;"&gt;CONCLUSION&lt;span style="font-weight:&amp;#xA;normal;mso-bidi-font-weight:bold"&gt; : Initiation of cART at a threshold CD4count of 0.500 × 10(9) cells/L increases AIDS-free survival. However, mortalitydid not vary substantially with the use of CD4 thresholds between 0.300 and0.500 × 10(9) cells/L.&lt;/span&gt;&lt;/span&gt;&lt;span style="font-size: 11pt; font-weight: normal;"&gt;&lt;/span&gt;&lt;/h4&gt;
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Logan, R.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Robins, J.M.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Sterne, J.A.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Sabin, C.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Bansi, L.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Justice, A.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Goulet, J.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name van Sighem, A.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name de Wolf, F.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Bucher, H.C.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name von Wyl, V.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Esteve, A.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Casabona, J.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name del Amo, J.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Moreno, S.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Seng, R.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Meyer, L.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Perez-Hoyos, S.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Muga, R.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Lodi, S.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Lanoy, E.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Costagliola, D.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Hernan, M.A.
710 ## - ADDED ENTRY--CORPORATE NAME
Corporate name or jurisdiction name as entry element The HIV-CAUSAL Collaboration
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610527/">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610527/</a>
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        Staff publications for NMDX Ferriman information and Library Service (North Middlesex) Ferriman information and Library Service (North Middlesex) Shelves 07/06/2022   07/06/2022 07/06/2022 Book
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