9TH EUROPEAN AIDS CONFERENCE (EACS)
1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

 October 25 - 29, 2003 Warsaw, Poland

18.4 Morbidity/Mortality in the Era of HAART

 F9/8 - STABLE PARTNERSHIP AND PROGRESSION TO AIDS OR DEATH IN HIV-INFECTED INDIVIDUALS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: THE SWISS HIV COHORT STUDY
* Bucher H.C. (1,10), Young J.1, DeGeest S.2, Spirig R.2, Flepp M.3, Rickenbach M.4, Furrer H.J.5, Bernasconi E.6, Hirschel B.7, Telenti A.8, Vernazza P.9, Battegay M.10
 
(1) Basel Institute for Clinical Epidemiology, University Hospital Basel, Switzerland,2 Institute for Nursing Science, University of Basel, Switzerland,3 University Hospital Zurich, Switzerland,4 Swiss HIV Cohort Data Centre, Lausanne, Switzerland,5 Inselspital Berne, Switzerland,6 Ospedale Civico, Lugano, Switzeralnd,7 Hôpital Universitaire de Genève, Switzerland,8 CHUV Lausanne, Switzerland,9 Kantonsspital St. Gallen, Switzerland,10 University Hospital Basel, Switzerland
 

Background: The impact of social relationships on hard clinical outcome in HIV infection is unknown.

Objectives: To explore the association between a stable partnership and clinical outcome in HIV-infected individuals receiving highly active antiretroviral therapy (HAART).

Methods: Prospective cohort study of 3736 patients with HIV included into Swiss HIV Cohort Study,who started HAART prior to 2002 (median age 36, 29% females, median follow-up 3.6 years). Outcomes were time to AIDS or death (primary endpoint), death alone, increases in CD4 cell count of at least 50 and 100 above baseline, optimal viral suppression (a viral load below 400 copies / ml), and viral rebound.

Results: During follow-up 2985 individuals (80%) report a stable partnership on at least one occasion. When starting HAART, 52% of individuals report a stable partnership; after five years of follow-up 46% of individuals report a stable partnership. In an analysis stratified by prior antiretroviral therapy and clinical stage when starting HAART (CDC group A, B or C), the adjusted hazard ratio for progression to AIDS or death is 0.79 [95 % CI 0.63 - 0.98] for those with a stable partnership compared to those without. Adjusted hazards ratios for other endpoints are: 0.59 [0.44 - 0.79] for progression to death, 1.15 [1.06 - 1.24] for a CD4 cell increase of 100 counts per ml or more, and 1.06 [0.98 - 1.14] for optimal viral suppression.

Conclusions: A stable partnership is associated with a slower rate of progression to AIDS or death in HIV-infected individuals receiving HAART.

Presenting Author: Dr. Heiner Bucher, Basel Insitute for Clinical Epidemiology, Kantonsspital Basel, CH-4031, Basel, Switzerland, Phone: 0041-61-265 3100

031025
50