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11th Annual Conference Of The British HIV Association [BHIVA]20–23 April 2005, Burlington Hotel·Dublin·Ireland |
[AUTHOR(S):] A Rider1, RJC Gilson1, A Copas1 and CA Sabin2, on behalf of the UK CHIC Steering Committee
1Centre for Sexual Health and HIV Research, 2Department of Primary Care and Population Sciences, Royal Free and University College Medical School , University College London, London, UK
BHIVA Conf 2005 Apr 20-23;11:O22
OBJECTIVES: To examine the impact on survival and disease progression of a discordant CD4:viral load (VL) response at 8 and 12 months after starting HAART in the UK CHIC Study.
METHODS: Patients with VL<50 copies/ml at 8m and 12m were divided into those with a rise in CD4 from baseline of <100 (discordant response) or >100cells/mm3 (non-discordant response). Incidence rate ratios (IRR) for the effect of a discordant response on mortality and AIDS were calculated using multiple Poisson regression.
RESULTS: 6120 ART-naïve patients started HAART of whom 1205 had baseline and follow-up CD4/VL data and VL<50 at 8m, and 1089 at 12m, of whom 494 (41%) and 351 (32%) had discordant responses respectively. Discordant responses were associated with an increased risk of death at 8m (6 deaths in the discordant group, 4 in the non-discordant; IRR=2.23; 95% CI [0.63,7.89]) and 12m (7 vs. 4; IRR=3.94 [1.15,13.46]), but a discordant response had little effect on the incidence of AIDS (312 and 282 events from 8m and 12m respectively).
DISCUSSION: Many patients have sub-optimal increases in CD4 count after starting HAART. Discordant responses at 12 and possibly 8 months may be associated with poorer outcome, although few deaths were reported in this cohort study.
PRESENTING AUTHOR: RJC Gilson
2005-04-20
O22
Copyright © 2005 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD