Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4
We studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4). We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). T...
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| Published in: | PloS one Vol. 12; no. 10; p. e0184441 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Public Library of Science
02.10.2017
Public Library of Science (PLoS) |
| Subjects: | |
| ISSN: | 1932-6203, 1932-6203 |
| Online Access: | Get full text |
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| Summary: | We studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4).
We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). Those with ≥8 years of known HIV infection and a CD4 cell nadir ≥500/mm3 were classified as LTNP and those with ≥10 years of known HIV infection and 90% of plasma viral load (VL) values ≤500 copies/ml in the absence of cART as HIC. cART initiation without loss of status and death from non AIDS-defining causes were considered as competing events.
After 5 years of follow-up, 33% (95%CI; 27-42) of 171 LTNP patients and 17% (95%CI; 10-30) of 72 HIC patients had lost their status. In multivariable analyses, loss of LTNP status was associated with lower baseline CD4 cell counts and CD4/CD8 ratios. Only VL was significantly associated with loss of HIC status after adjustment for the baseline CD4 cell count, the CD4/CD8 ratio, and concomitant LTNP status. The hazard ratio for loss of HIC status was 5.5 (95%CI, 1.5-20.1) for baseline VL 50-500 vs ≤50 cp/mL, after adjustment for the baseline CD4 cell count.
One-third of LTNP and one-fifth of HIC patients lost their status after 5 years of follow-up, raising questions as to the possible benefits and timing of ART initiation in these populations. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 PMCID: PMC5624574 Competing Interests: Dominique Costagliola was a member of the French Gilead HIV board up to 2015. In the past 3 years, she gave lectures for Janssen-Cilag, Merck-Sharp & Dohme-Chibret, ViiV and received travel/accommodations/meeting expenses from Gilead, ViiV, Janssen-Cilag. She conducted post-marketing studies for Janssen-Cilag, Merck-Sharp & Dohme-Chibret and ViiV. She is currently a consultant for Innavirvax. Laurence Weiss was a member of the Advisory board for Bristol Myers Squibb (up to 2015), of the Regional Advisory board Gilead (2016). In the past 3 years, he gave lectures for Janssen-Cilag, Merck-Sharp & Dohme-Chibret and received travel/accommodations/meeting expenses from Gilead, Bristol Myers Squibb, and Janssen-Cilag. He is currently a consultant for Bristol Myers Squibb (immune-oncology). Sophie Abgrall is a member of the French Janssen-Cilag board. In the past 3 years, she gave lectures for Gilead and ViiV, and received travel/accommodations expenses from Gilead, ViiV and Janssen-Cilag. Sophie Grabar gave a lecture for Gilead. Gilles Pialoux have received research grants from Gilead and BMS. He participated on advisory boards or received travel/accommodations expenses from Gilead, MSD, Janssen, BMS, Abbvie and ViiVhealthcare. This does not alter our adherence to PLOS ONE policies on sharing data and materials. |
| ISSN: | 1932-6203 1932-6203 |
| DOI: | 10.1371/journal.pone.0184441 |