Key points are not available for this paper at this time.
PROGNOSIS OF HIV-1-INFECTED PATIENTS STARTING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: A COLLABORATIVE ANALYSIS OF PROSPECTIVE STUDIES Egger M et al. Lancet 2002;360:119 The authors pooled data from 13 cohort studies from Europe and North America to define the prognosis of HIV infection in patients treated with HAART. There were data for 12,574 adult patients followed for 24,310 person-years after initiating an antiretroviral regimen with at least three drugs. The major endpoints were the development of an AIDS-defining diagnosis, which was found in 1,094 patients or death in 344. The outcome was correlated with multiple variables, including CD4 cell count and viral load at baseline (prior to initiation of HAART), risk category, age, and sex. The dominant factor in outcome was the baseline CD4 cell count. Other significant correlates with poor outcome were age over 50 years, injection drug use and a previous diagnosis of AIDS. There was no significant correlation with baseline viral load. Hazard ratios for the endpoint of AIDS or death are summarized in Table 7.TABLE 7Comment: The major surprise in this study is the failure of viral load to predict clinical progression, except in the group with a baseline level exceeding 100,000 c/mL. This observation is in contrast to that previously reported by Mellors et al. based on data that preceded the HAART era Ann Intern Med 1997;126:946.
A 2002 study studied this question.