Salzberger, Bernd and Hartmann, P. and Hanses, Frank and Uyanik, B. and Cornely, O. A. and Woehrmann, A. and Faetkenheuer, G. (2005) Incidence and prognosis of CMV disease in HIV-infected patients before and after introduction of combination antiretroviral therapy. INFECTION, 33 (5-6). pp. 345-349. ISSN 0300-8126,
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Background: Highly active antiretroviral therapy (HAART) has improved the prognosis of HIV-infected patients. We studied the changes in the incidence and prognosis of cytomegalovirus (CMV) disease preceding and during the first few years of HAART in a clinic cohort. Patients and Methods: ALL patients with CMV disease diagnosed between 1993 and 1999 from a clinic cohort in Cologne, Germany, were included. The patients were followed until death or until December 31, 2001. The time period from 1993-1996 was classified as pre-HAART, the period from 1997-1999 as the HAART era. Survival was analyzed with a Cox-proportional hazard model. Results: From a total of 1,279 HIV-infected patients, 127 patients with CMV disease were enrolled. The incidence of CMV disease declined rapidly and significantly from 7.34 cases per 100 patient years (py) in the pre-HAART era to 0.75 cases per 100 py in the HAART era. The median survival time in the pre-HAART era was 9.5 months; the median survival was not yet reached at 4 years of follow-up in the HAART era. The only risk factors influencing survival were CD4-cell count and antiretroviral therapy before and after diagnosis of CMV disease. Treatment naive patients had a better prognosis than pretreated patients and patients treated with triple combination therapy survived Longer than patients with other treatment modalities. Conclusion: A rapid decline in the incidence of new CMV manifestations and a better prognosis of patients with CMV disease, especially if they were treatment naive and treated with triple combination therapy, were observed in the HAART era.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CYTOMEGALOVIRUS RETINITIS; PROTEASE INHIBITORS; NATURAL-HISTORY; SURVIVAL; RISK; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Apr 2021 09:10 |
| Last Modified: | 26 Apr 2021 09:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/35581 |
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