Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes

Bruno Ledergerber, Jens D. Lundgren, A. Sarah Walker, Caroline Sabin, Amy Justice, Peter Reiss, Cristina Mussini, Ferdinand Wit, Antonella d'Arminio Monforte, Rainer Weber, Gregory Fusco, Schlomo Staszewski, Matthew Law, Robert Hogg, Fiona Lampe, M. John Gill, Francesco Castelli, Andrew N. Phillips, P. Rooney, S. TaylorD. Couldwell, D. Austin, M. Block, J. Clemons, R. Finlayson, K. Petoumenos, D. Quan, D. Smith, C. O'Connor, C. Gorton, D. Allen, B. Mulhall, K. Mutimer, N. Keeffe, D. Cooper, A. Carr, J. Miller, C. Pell, D. Ellis, D. Baker, J. Kidd, R. McFarlane, M. T. Liang, K. Brown, S. Huffam, J. Savage, S. Morgan, P. Knibbs, D. Sowden, A. Walker, D. Orth, G. Lister, J. Chuah, W. Fankhauser, B. Dickson, D. Bradford, C. Wilson, H. Ree, H. Magon, J. Anderson, R. Moore, D. Russell, G. McGovern, R. McNair, J. Bal, K. Fairley, N. Roth, B. Eu, S. Strecker, D. Russell, H. Wood, A. Mijch, J. Hoy, A. Pierce, C. McCormack, K. Watson, N. Medland, J. Daye, S. Mallal, M. French, J. Skett, D. Maxwel, A. Cain, M. Montroni, G. Scalise, A. Costantini, A. Giacometti, U. Tirelli, G. Nasti, G. Pastore, N. Ladisa, M. L. Perulli, G. Pastore, N. Ladisa, F. Suter, C. Arici, F. Suter, F. Maggiolo, F. Chiodo, F. M. Gritti, V. Colangeli, C. Fiorini, L. Guerra, G. Carosi, G. P. Cadeo, C. Minardi, D. Vangi, G. Carosi, G. Paraninfo, S. Casari, A. Pan, A. Patroni, C. Torti, E. Quiros-Roldan, L. Tomasoni, F. Moretti, P. Nasta, M. C. Uccelli, G. P. Cadeo, D. Bertelli, G. Rizzardini, G. Migliorino, G. Rizzardini, M. Migliorino, C. Abeli, P. E. Manconi, P. Piano, T. Ferraro, A. Scerbo, E. Pizzigallo, F. Ricci, D. Santoro, L. Pusterla, G. Carnevale, D. Galloni, G. Carnevale, P. Viganò, M. Mena, F. Ghinelli, L. Sighinolfi, F. Ghinelli, L. Sighinolfi, F. Leoncini, F. Mazzotta, M. Pozzi, S. Lo Caputo, G. Angarano, B. Grisorio, S. Ferrara, P. Grima, P. Tundo, G. Pagano, N. Piersantelli, A. Alessandrini, R. Piscopo, M. Toti, S. Chigiotti, F. Soscia, L. Tacconi, A. Orani, P. Perini, A. Orani, P. Perini, M. Nigro, A. Scasso, A. Vincenti, A. Scalzini, G. Fibbia, M. Moroni, A. Lazzarin, A. Cargnel, G. M. Vigevani, L. Caggese, F. Tordato, R. Novati, A. Galli, S. Merli, C. Pastecchia, C. Moioli, R. Esposito, N. Abrescia, A. Chirianni, C. Izzo, M. Piazza, M. De Marco, V. Montesarchio, E. Manzillo, S. Nappa, A. Colomba, V. Abbadessa, T. Prestileo, S. Mancuso, C. Ferrari, P. Pzzaferri, G. Filice, L. Minoli, R. Bruno, R. Maserati, L. Minoli, R. Maserati, S. Novati, C. Tinelli, S. Pauluzzi, F. Baldelli, E. Petrelli, A. Cioppi, F. Alberici, A. Ruggieri, F. Menichetti, C. Martinelli, C. De Stefano, A. La Gala, T. Zauli, G. Ballardini, G. Magnani, M. A. Ursitti, M. Arlotti, P. Ortolani, L. Ortona, F. Dianzani, G. Ippolito, A. Antinori, G. Antonucci, S. D'Elia, P. Narciso, N. Petrosillo, V. Vullo, A. De Luca, L. Del Forno, M. Zaccarelli, P. De Longis, M. Ciardi, G. D'Offizi, P. Noto, M. Lichtner, M. R. Capobianchi, E. Girardi, P. Pezzotti, G. Rezza, M. S. Mura, M. Mannazzu, P. Caramello, A. Sinicco, M. L. Soranzo, L. Gennero, M. Sciandra, B. Salassa, P. A. Grossi, C. Basilico, A. Poggio, G. Bottari, A. Poggio, E. Raise, S. Pasquinucci, F. De Lalla, G. Tositti, F. Resta, A. Chimienti, A. Lepri Cozzi, S. Bachmann, M. Battegay, E. Bernasconi, H. Bucher, P. Bürgisser, S. Cattacin, M. Egger, P. Erb, W. Fierz, M. Fischer, M. Flepp, A. Fontana, P. Francioli, H. J. Furrer, M. Gorgievski, H. Günthard, B. Hirschel, L. Kaiser, C. Kind, T. Klimkait, U. Lauper, M. Opravil, F. Paccaud, G. Pantaleo, L. Perrin, J. C. Piffaretti, M. Rickenbach, C. Rudin, J. Schüpbach, R. Speck, P. Tarr, A. Telenti, A. Trkola, P. Vernazza, S. Yerly, F. de Wolf, A. I. van Sighem, I. van Valkengoed, L. Gras, W. Bronsveld, A. Veldkamp, J. M. Prins, J. C. Bos, J. K M Schattenkerk Eeftinck, M. H. Godfried, J. M A Lange, S. H. Lowe, J. T M van der Meer, F. J B Nellen, K. Pogany, T. van der Poll, T. A. Ruys, S. Sankatsing, M. van der Valk, M. G A van Vonderen, F. W M N Wit, A. van Eeden, J. H. ten Veen, P. S. van Dam, M. E. Hillebrand-Haverkort, K. Brinkman, P. H J Frissen, H. M. Weigel, J. W. Mulder, E. C M van Gorp, P. L. Meenhorst, A. T A Mairuhu, J. Veenstra, S. A. Danner, M. A. Van Agtmael, F. A P Claessen, S. E. Geerlings, R. M. Perenboom, S. Jurriaans, N. K T Back, T. Cuijpers, P. J G M Rietra, K. J. Roozendaal, W. Pauw, A. P. van Zanten, P. H M Smits, B. M E von Blomberg, P. Savelkoul, H. Zaaijer, J. H. Beijnen, K. M L Crommentuyn, A. D R Huitema, B. Kappelhoff, M. M R de Maat, C. Richter, J. van der Berg, R. van Leusen, C. Swanink, R. Vriesendorp, F. J F Jeurissen, R. H. Kauffmann, E. L W Koger, P. F H Franck, A. S. Lampe, C. L. Jansen, B. Bravenboer, C. H H ten Napel, T. Mudrikova, R. Hendriks, H. G. Sprenger, W. M A J Miesen, J. Schirm, D. Benne, R. W. ten Kate, D. Veenendaal, D. P F van Houte, M. P. Leemhuis, M. Pole, H. Storm, J. H. van Zeijl, F. P. Kroon, E. F. Schippers, A. C M Kroes, H. C J Claas, G. Schreij, S. van de Geest, A. Verbon, C. A M V A Bruggeman, V. J. Goossens, P. P. Koopmans, M. Telgt, A. J A M van der Ven, D. M. Burger, P. W H Hugen, J. M D Galama, Y. A G M Poort, M. E. van der Ende, I. C. Gyssens, S. de Marie, J. L. Nouwen, M. G. Niesters, A. D M E Osterhaus, M. Schutten, J. R. Juttmann, A. G M Buiting, C. A M Swaans, M. M E Schneider, M. J M Bonten, J. C C Borleffs, I. M. Hoepelman, C. A J J Jaspers, I. Schouten, C. A M Schurink, C. A B Boucher, R. Schuurman, W. L. Blok, P. H P Groeneveld, E. Boel, A. F. Jansz, F. Dabis, R. Thiebaut, G. Chêne, S. Lawson-Ayayi, L. Meyer, F. Boufassa, O. Hamouda, P. Pezzotti, G. Rezza, G. Touloumi, A. Hatzakis, A. Karafoulidou, O. Katsarou, R. Brettle, J. Del Amo, J. del Romero, L. van Asten, B. van Benthem, M. Prins, R. Coutinho, O. Kirk, C. Pedersen, I. Hernández Aguado, S. Pérez-Hoyos, A. Eskild, J. N. Bruun, M. Sannes, C. Lee, A. M. Johnson, A. Babiker, J. Darbyshire, N. Gill, K. Porter, P. Francioli, P. Vanhems, M. Egger, M. Rickenbach, D. Cooper, J. Kaldor, L. Ashton, D. Cooper, J. Kaldor, L. Ashton, J. Vizzard, R. Muga, P. Vanhems, J. Gill, J. Cayla, P. Garcia de Olalla, N. E. Day, D. De Angelis, K. Porter, A. Babiker, S. Walker, J. Darbyshire, F. Tyrer, V. Beral, R. Coutinho, J. Darbyshire, J. Del Amo, N. Gill, C. Lee, L. Meyer, G. Rezza, S. Raffanti, S. Becker, A. Scarsella, J. Braun, B. Most, R. Balu, L. Gilbert, R. Fleenor, T. Ising, D. Dieterich, J. Fusco, M. Losso, D. Bánhegyi, N. Vetter, N. Clumeck, S. De Wit, K. Kabeya, B. Poll, R. Colebunders, L. Machala, H. Rozsypal, J. Nielsen, J. Lundgren, O. Kirk, C. H. Olsen, J. Gerstoft, T. Katzenstein, A. B E Hansen, P. Skinhøj, C. Pedersen, K. Zilmer, M. Rauka, C. Katlama, M. De Sa, J. P. Viard, T. Saint-Marc, P. Vanhems, C. Pradier, M. Dietrich, C. Manegold, J. van Lunzen, H. J. Stellbrink, V. Miller, F. D. Goebel, B. Salzberger, J. Rockstroh, J. Kosmidis, P. Gargalianos, H. Sambatakou, J. Perdios, G. Panos, A. Filandras, D. Banhegyi, F. Mulcahy, I. Yust, M. Burke, S. Pollack, J. Hassoun, Z. Sthoeger, S. Maayan, S. Vella, A. Chiesi, C. Arici, R. Pristerá, F. Mazzotta, A. Gabbuti, R. Esposito, A. Bedini, A. Chirianni, E. Montesarchio, V. Vullo, P. Santopadre, P. Narciso, A. Antinori, P. Franci, M. Zaccarelli, A. Lazzarin, A. Castagna, L. Viksna, B. Rozentale, S. Chaplinskas, R. Hemmer, T. Staub, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, A. Horban, D. Prokopowicz, A. Wiercinska-Drapalo, A. Boron-Kaczmarska, M. Pynka, M. Beniowski, H. Trocha, T. Smiatacz, F. Antunes, K. Mansinho, F. Maltez, D. Duiculescu, A. Streinu-Cercel, M. Mokrás, D. Staneková, J. González-Lahoz, B. Diaz, T. García-Benayas, L. Martin-Carbonero, V. Soriano, B. Clotet, A. Jou, J. Conejero, C. Tural, J. M. Gatell, J. M. Miró, L. Zamora, A. Blaxhult, A. Karlsson, P. Pehrson, P. Francioli, B. Hirschel, V. Schiffer, H. Furrer, N. Chentsova, S. Barton, A. M. Johnson, D. Mercey, A. Phillips, M. Youle, M. A. Johnson, A. Mocroft, M. Murphy, J. Weber, G. Scullard, M. Fisher, R. Brettle, C. Loveday, B. Clotet, L. Ruiz, E. B. Helm, A. Carlebach, M. Mösch, A. Müller, A. Haberl, S. Korn, C. Stephan, M. Bickel, P. Gute, L. Locher, T. Lutz, S. Klauke, H. W. Doerr, M. Stürmer, B. Dauer, B. Jennings, C. Alexander, P. Braitstein, K. Chan, H. Cote, N. Gataric, P. R. Harrigan, M. Harris, S. Bonner, J. Montaner, M. O'Shaughnessy, E. Wood, B. Yip, C. Chaloner, H. Gumley, D. Ransom, C. A. Sabin, A. Mocroft, M. Lipman, M. Youle, M. Johnson, J. Gill, R. Read, F. Mazzotta, G. Riccio, V. Borghi, A. Bedini, R. Esposito

Research output: Contribution to journalArticle

245 Citations (Scopus)

Abstract

Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure. Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models. Findings 2488 patients were included. 2118 (85%) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5·5 per 100 person-years; 3-year mortality risk 15·3% (95% CI 13·5-17·3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15·8 (95% CI 9·28-27·0) for counts below 50 cells per μL versus above 200 cells per μL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1·5 log 10 copies per mL below off-treatment values. Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per μL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1·5 log10 copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.

Original languageEnglish
Pages (from-to)51-62
Number of pages12
JournalThe Lancet
Volume364
Issue number9428
DOIs
Publication statusPublished - Jul 3 2004

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HIV-1
Viral Load
Cell Count
CD4 Lymphocyte Count
T-Lymphocytes
Mortality
Pharmaceutical Preparations
Therapeutics
HIV
North America
Proportional Hazards Models
Regression Analysis
Maintenance
Demography
RNA

ASJC Scopus subject areas

  • Medicine(all)

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Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes. / Ledergerber, Bruno; Lundgren, Jens D.; Sarah Walker, A.; Sabin, Caroline; Justice, Amy; Reiss, Peter; Mussini, Cristina; Wit, Ferdinand; d'Arminio Monforte, Antonella; Weber, Rainer; Fusco, Gregory; Staszewski, Schlomo; Law, Matthew; Hogg, Robert; Lampe, Fiona; John Gill, M.; Castelli, Francesco; Phillips, Andrew N.; Rooney, P.; Taylor, S.; Couldwell, D.; Austin, D.; Block, M.; Clemons, J.; Finlayson, R.; Petoumenos, K.; Quan, D.; Smith, D.; O'Connor, C.; Gorton, C.; Allen, D.; Mulhall, B.; Mutimer, K.; Keeffe, N.; Cooper, D.; Carr, A.; Miller, J.; Pell, C.; Ellis, D.; Baker, D.; Kidd, J.; McFarlane, R.; Liang, M. T.; Brown, K.; Huffam, S.; Savage, J.; Morgan, S.; Knibbs, P.; Sowden, D.; Walker, A.; Orth, D.; Lister, G.; Chuah, J.; Fankhauser, W.; Dickson, B.; Bradford, D.; Wilson, C.; Ree, H.; Magon, H.; Anderson, J.; Moore, R.; Russell, D.; McGovern, G.; McNair, R.; Bal, J.; Fairley, K.; Roth, N.; Eu, B.; Strecker, S.; Russell, D.; Wood, H.; Mijch, A.; Hoy, J.; Pierce, A.; McCormack, C.; Watson, K.; Medland, N.; Daye, J.; Mallal, S.; French, M.; Skett, J.; Maxwel, D.; Cain, A.; Montroni, M.; Scalise, G.; Costantini, A.; Giacometti, A.; Tirelli, U.; Nasti, G.; Pastore, G.; Ladisa, N.; Perulli, M. L.; Pastore, G.; Ladisa, N.; Suter, F.; Arici, C.; Suter, F.; Maggiolo, F.; Chiodo, F.; Gritti, F. M.; Colangeli, V.; Fiorini, C.; Guerra, L.; Carosi, G.; Cadeo, G. P.; Minardi, C.; Vangi, D.; Carosi, G.; Paraninfo, G.; Casari, S.; Pan, A.; Patroni, A.; Torti, C.; Quiros-Roldan, E.; Tomasoni, L.; Moretti, F.; Nasta, P.; Uccelli, M. C.; Cadeo, G. P.; Bertelli, D.; Rizzardini, G.; Migliorino, G.; Rizzardini, G.; Migliorino, M.; Abeli, C.; Manconi, P. E.; Piano, P.; Ferraro, T.; Scerbo, A.; Pizzigallo, E.; Ricci, F.; Santoro, D.; Pusterla, L.; Carnevale, G.; Galloni, D.; Carnevale, G.; Viganò, P.; Mena, M.; Ghinelli, F.; Sighinolfi, L.; Ghinelli, F.; Sighinolfi, L.; Leoncini, F.; Mazzotta, F.; Pozzi, M.; Lo Caputo, S.; Angarano, G.; Grisorio, B.; Ferrara, S.; Grima, P.; Tundo, P.; Pagano, G.; Piersantelli, N.; Alessandrini, A.; Piscopo, R.; Toti, M.; Chigiotti, S.; Soscia, F.; Tacconi, L.; Orani, A.; Perini, P.; Orani, A.; Perini, P.; Nigro, M.; Scasso, A.; Vincenti, A.; Scalzini, A.; Fibbia, G.; Moroni, M.; Lazzarin, A.; Cargnel, A.; Vigevani, G. M.; Caggese, L.; Tordato, F.; Novati, R.; Galli, A.; Merli, S.; Pastecchia, C.; Moioli, C.; Esposito, R.; Abrescia, N.; Chirianni, A.; Izzo, C.; Piazza, M.; De Marco, M.; Montesarchio, V.; Manzillo, E.; Nappa, S.; Colomba, A.; Abbadessa, V.; Prestileo, T.; Mancuso, S.; Ferrari, C.; Pzzaferri, P.; Filice, G.; Minoli, L.; Bruno, R.; Maserati, R.; Minoli, L.; Maserati, R.; Novati, S.; Tinelli, C.; Pauluzzi, S.; Baldelli, F.; Petrelli, E.; Cioppi, A.; Alberici, F.; Ruggieri, A.; Menichetti, F.; Martinelli, C.; De Stefano, C.; La Gala, A.; Zauli, T.; Ballardini, G.; Magnani, G.; Ursitti, M. A.; Arlotti, M.; Ortolani, P.; Ortona, L.; Dianzani, F.; Ippolito, G.; Antinori, A.; Antonucci, G.; D'Elia, S.; Narciso, P.; Petrosillo, N.; Vullo, V.; De Luca, A.; Del Forno, L.; Zaccarelli, M.; De Longis, P.; Ciardi, M.; D'Offizi, G.; Noto, P.; Lichtner, M.; Capobianchi, M. R.; Girardi, E.; Pezzotti, P.; Rezza, G.; Mura, M. S.; Mannazzu, M.; Caramello, P.; Sinicco, A.; Soranzo, M. L.; Gennero, L.; Sciandra, M.; Salassa, B.; Grossi, P. A.; Basilico, C.; Poggio, A.; Bottari, G.; Poggio, A.; Raise, E.; Pasquinucci, S.; De Lalla, F.; Tositti, G.; Resta, F.; Chimienti, A.; Lepri Cozzi, A.; Bachmann, S.; Battegay, M.; Bernasconi, E.; Bucher, H.; Bürgisser, P.; Cattacin, S.; Egger, M.; Erb, P.; Fierz, W.; Fischer, M.; Flepp, M.; Fontana, A.; Francioli, P.; Furrer, H. J.; Gorgievski, M.; Günthard, H.; Hirschel, B.; Kaiser, L.; Kind, C.; Klimkait, T.; Lauper, U.; Opravil, M.; Paccaud, F.; Pantaleo, G.; Perrin, L.; Piffaretti, J. C.; Rickenbach, M.; Rudin, C.; Schüpbach, J.; Speck, R.; Tarr, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Yerly, S.; de Wolf, F.; van Sighem, A. I.; van Valkengoed, I.; Gras, L.; Bronsveld, W.; Veldkamp, A.; Prins, J. M.; Bos, J. C.; Schattenkerk Eeftinck, J. K M; Godfried, M. H.; Lange, J. M A; Lowe, S. H.; van der Meer, J. T M; Nellen, F. J B; Pogany, K.; van der Poll, T.; Ruys, T. A.; Sankatsing, S.; van der Valk, M.; van Vonderen, M. G A; Wit, F. W M N; van Eeden, A.; ten Veen, J. H.; van Dam, P. S.; Hillebrand-Haverkort, M. E.; Brinkman, K.; Frissen, P. H J; Weigel, H. M.; Mulder, J. W.; van Gorp, E. C M; Meenhorst, P. L.; Mairuhu, A. T A; Veenstra, J.; Danner, S. A.; Van Agtmael, M. A.; Claessen, F. A P; Geerlings, S. E.; Perenboom, R. M.; Jurriaans, S.; Back, N. K T; Cuijpers, T.; Rietra, P. J G M; Roozendaal, K. J.; Pauw, W.; van Zanten, A. P.; Smits, P. H M; von Blomberg, B. M E; Savelkoul, P.; Zaaijer, H.; Beijnen, J. H.; Crommentuyn, K. M L; Huitema, A. D R; Kappelhoff, B.; de Maat, M. M R; Richter, C.; van der Berg, J.; van Leusen, R.; Swanink, C.; Vriesendorp, R.; Jeurissen, F. J F; Kauffmann, R. H.; Koger, E. L W; Franck, P. F H; Lampe, A. S.; Jansen, C. L.; Bravenboer, B.; ten Napel, C. H H; Mudrikova, T.; Hendriks, R.; Sprenger, H. G.; Miesen, W. M A J; Schirm, J.; Benne, D.; ten Kate, R. W.; Veenendaal, D.; van Houte, D. P F; Leemhuis, M. P.; Pole, M.; Storm, H.; van Zeijl, J. H.; Kroon, F. P.; Schippers, E. F.; Kroes, A. C M; Claas, H. C J; Schreij, G.; van de Geest, S.; Verbon, A.; Bruggeman, C. A M V A; Goossens, V. J.; Koopmans, P. P.; Telgt, M.; van der Ven, A. J A M; Burger, D. M.; Hugen, P. W H; Galama, J. M D; Poort, Y. A G M; van der Ende, M. E.; Gyssens, I. C.; de Marie, S.; Nouwen, J. L.; Niesters, M. G.; Osterhaus, A. D M E; Schutten, M.; Juttmann, J. R.; Buiting, A. G M; Swaans, C. A M; Schneider, M. M E; Bonten, M. J M; Borleffs, J. C C; Hoepelman, I. M.; Jaspers, C. A J J; Schouten, I.; Schurink, C. A M; Boucher, C. A B; Schuurman, R.; Blok, W. L.; Groeneveld, P. H P; Boel, E.; Jansz, A. F.; Dabis, F.; Thiebaut, R.; Chêne, G.; Lawson-Ayayi, S.; Meyer, L.; Boufassa, F.; Hamouda, O.; Pezzotti, P.; Rezza, G.; Touloumi, G.; Hatzakis, A.; Karafoulidou, A.; Katsarou, O.; Brettle, R.; Del Amo, J.; del Romero, J.; van Asten, L.; van Benthem, B.; Prins, M.; Coutinho, R.; Kirk, O.; Pedersen, C.; Hernández Aguado, I.; Pérez-Hoyos, S.; Eskild, A.; Bruun, J. N.; Sannes, M.; Lee, C.; Johnson, A. M.; Babiker, A.; Darbyshire, J.; Gill, N.; Porter, K.; Francioli, P.; Vanhems, P.; Egger, M.; Rickenbach, M.; Cooper, D.; Kaldor, J.; Ashton, L.; Cooper, D.; Kaldor, J.; Ashton, L.; Vizzard, J.; Muga, R.; Vanhems, P.; Gill, J.; Cayla, J.; Garcia de Olalla, P.; Day, N. E.; De Angelis, D.; Porter, K.; Babiker, A.; Walker, S.; Darbyshire, J.; Tyrer, F.; Beral, V.; Coutinho, R.; Darbyshire, J.; Del Amo, J.; Gill, N.; Lee, C.; Meyer, L.; Rezza, G.; Raffanti, S.; Becker, S.; Scarsella, A.; Braun, J.; Most, B.; Balu, R.; Gilbert, L.; Fleenor, R.; Ising, T.; Dieterich, D.; Fusco, J.; Losso, M.; Bánhegyi, D.; Vetter, N.; Clumeck, N.; De Wit, S.; Kabeya, K.; Poll, B.; Colebunders, R.; Machala, L.; Rozsypal, H.; Nielsen, J.; Lundgren, J.; Kirk, O.; Olsen, C. H.; Gerstoft, J.; Katzenstein, T.; Hansen, A. B E; Skinhøj, P.; Pedersen, C.; Zilmer, K.; Rauka, M.; Katlama, C.; De Sa, M.; Viard, J. P.; Saint-Marc, T.; Vanhems, P.; Pradier, C.; Dietrich, M.; Manegold, C.; van Lunzen, J.; Stellbrink, H. J.; Miller, V.; Goebel, F. D.; Salzberger, B.; Rockstroh, J.; Kosmidis, J.; Gargalianos, P.; Sambatakou, H.; Perdios, J.; Panos, G.; Filandras, A.; Banhegyi, D.; Mulcahy, F.; Yust, I.; Burke, M.; Pollack, S.; Hassoun, J.; Sthoeger, Z.; Maayan, S.; Vella, S.; Chiesi, A.; Arici, C.; Pristerá, R.; Mazzotta, F.; Gabbuti, A.; Esposito, R.; Bedini, A.; Chirianni, A.; Montesarchio, E.; Vullo, V.; Santopadre, P.; Narciso, P.; Antinori, A.; Franci, P.; Zaccarelli, M.; Lazzarin, A.; Castagna, A.; Viksna, L.; Rozentale, B.; Chaplinskas, S.; Hemmer, R.; Staub, T.; Bruun, J.; Maeland, A.; Ormaasen, V.; Knysz, B.; Gasiorowski, J.; Horban, A.; Prokopowicz, D.; Wiercinska-Drapalo, A.; Boron-Kaczmarska, A.; Pynka, M.; Beniowski, M.; Trocha, H.; Smiatacz, T.; Antunes, F.; Mansinho, K.; Maltez, F.; Duiculescu, D.; Streinu-Cercel, A.; Mokrás, M.; Staneková, D.; González-Lahoz, J.; Diaz, B.; García-Benayas, T.; Martin-Carbonero, L.; Soriano, V.; Clotet, B.; Jou, A.; Conejero, J.; Tural, C.; Gatell, J. M.; Miró, J. M.; Zamora, L.; Blaxhult, A.; Karlsson, A.; Pehrson, P.; Francioli, P.; Hirschel, B.; Schiffer, V.; Furrer, H.; Chentsova, N.; Barton, S.; Johnson, A. M.; Mercey, D.; Phillips, A.; Youle, M.; Johnson, M. A.; Mocroft, A.; Murphy, M.; Weber, J.; Scullard, G.; Fisher, M.; Brettle, R.; Loveday, C.; Clotet, B.; Ruiz, L.; Helm, E. B.; Carlebach, A.; Mösch, M.; Müller, A.; Haberl, A.; Korn, S.; Stephan, C.; Bickel, M.; Gute, P.; Locher, L.; Lutz, T.; Klauke, S.; Doerr, H. W.; Stürmer, M.; Dauer, B.; Jennings, B.; Alexander, C.; Braitstein, P.; Chan, K.; Cote, H.; Gataric, N.; Harrigan, P. R.; Harris, M.; Bonner, S.; Montaner, J.; O'Shaughnessy, M.; Wood, E.; Yip, B.; Chaloner, C.; Gumley, H.; Ransom, D.; Sabin, C. A.; Mocroft, A.; Lipman, M.; Youle, M.; Johnson, M.; Gill, J.; Read, R.; Mazzotta, F.; Riccio, G.; Borghi, V.; Bedini, A.; Esposito, R.

In: The Lancet, Vol. 364, No. 9428, 03.07.2004, p. 51-62.

Research output: Contribution to journalArticle

Ledergerber, B, Lundgren, JD, Sarah Walker, A, Sabin, C, Justice, A, Reiss, P, Mussini, C, Wit, F, d'Arminio Monforte, A, Weber, R, Fusco, G, Staszewski, S, Law, M, Hogg, R, Lampe, F, John Gill, M, Castelli, F, Phillips, AN, Rooney, P, Taylor, S, Couldwell, D, Austin, D, Block, M, Clemons, J, Finlayson, R, Petoumenos, K, Quan, D, Smith, D, O'Connor, C, Gorton, C, Allen, D, Mulhall, B, Mutimer, K, Keeffe, N, Cooper, D, Carr, A, Miller, J, Pell, C, Ellis, D, Baker, D, Kidd, J, McFarlane, R, Liang, MT, Brown, K, Huffam, S, Savage, J, Morgan, S, Knibbs, P, Sowden, D, Walker, A, Orth, D, Lister, G, Chuah, J, Fankhauser, W, Dickson, B, Bradford, D, Wilson, C, Ree, H, Magon, H, Anderson, J, Moore, R, Russell, D, McGovern, G, McNair, R, Bal, J, Fairley, K, Roth, N, Eu, B, Strecker, S, Russell, D, Wood, H, Mijch, A, Hoy, J, Pierce, A, McCormack, C, Watson, K, Medland, N, Daye, J, Mallal, S, French, M, Skett, J, Maxwel, D, Cain, A, Montroni, M, Scalise, G, Costantini, A, Giacometti, A, Tirelli, U, Nasti, G, Pastore, G, Ladisa, N, Perulli, ML, Pastore, G, Ladisa, N, Suter, F, Arici, C, Suter, F, Maggiolo, F, Chiodo, F, Gritti, FM, Colangeli, V, Fiorini, C, Guerra, L, Carosi, G, Cadeo, GP, Minardi, C, Vangi, D, Carosi, G, Paraninfo, G, Casari, S, Pan, A, Patroni, A, Torti, C, Quiros-Roldan, E, Tomasoni, L, Moretti, F, Nasta, P, Uccelli, MC, Cadeo, GP, Bertelli, D, Rizzardini, G, Migliorino, G, Rizzardini, G, Migliorino, M, Abeli, C, Manconi, PE, Piano, P, Ferraro, T, Scerbo, A, Pizzigallo, E, Ricci, F, Santoro, D, Pusterla, L, Carnevale, G, Galloni, D, Carnevale, G, Viganò, P, Mena, M, Ghinelli, F, Sighinolfi, L, Ghinelli, F, Sighinolfi, L, Leoncini, F, Mazzotta, F, Pozzi, M, Lo Caputo, S, Angarano, G, Grisorio, B, Ferrara, S, Grima, P, Tundo, P, Pagano, G, Piersantelli, N, Alessandrini, A, Piscopo, R, Toti, M, Chigiotti, S, Soscia, F, Tacconi, L, Orani, A, Perini, P, Orani, A, Perini, P, Nigro, M, Scasso, A, Vincenti, A, Scalzini, A, Fibbia, G, Moroni, M, Lazzarin, A, Cargnel, A, Vigevani, GM, Caggese, L, Tordato, F, Novati, R, Galli, A, Merli, S, Pastecchia, C, Moioli, C, Esposito, R, Abrescia, N, Chirianni, A, Izzo, C, Piazza, M, De Marco, M, Montesarchio, V, Manzillo, E, Nappa, S, Colomba, A, Abbadessa, V, Prestileo, T, Mancuso, S, Ferrari, C, Pzzaferri, P, Filice, G, Minoli, L, Bruno, R, Maserati, R, Minoli, L, Maserati, R, Novati, S, Tinelli, C, Pauluzzi, S, Baldelli, F, Petrelli, E, Cioppi, A, Alberici, F, Ruggieri, A, Menichetti, F, Martinelli, C, De Stefano, C, La Gala, A, Zauli, T, Ballardini, G, Magnani, G, Ursitti, MA, Arlotti, M, Ortolani, P, Ortona, L, Dianzani, F, Ippolito, G, Antinori, A, Antonucci, G, D'Elia, S, Narciso, P, Petrosillo, N, Vullo, V, De Luca, A, Del Forno, L, Zaccarelli, M, De Longis, P, Ciardi, M, D'Offizi, G, Noto, P, Lichtner, M, Capobianchi, MR, Girardi, E, Pezzotti, P, Rezza, G, Mura, MS, Mannazzu, M, Caramello, P, Sinicco, A, Soranzo, ML, Gennero, L, Sciandra, M, Salassa, B, Grossi, PA, Basilico, C, Poggio, A, Bottari, G, Poggio, A, Raise, E, Pasquinucci, S, De Lalla, F, Tositti, G, Resta, F, Chimienti, A, Lepri Cozzi, A, Bachmann, S, Battegay, M, Bernasconi, E, Bucher, H, Bürgisser, P, Cattacin, S, Egger, M, Erb, P, Fierz, W, Fischer, M, Flepp, M, Fontana, A, Francioli, P, Furrer, HJ, Gorgievski, M, Günthard, H, Hirschel, B, Kaiser, L, Kind, C, Klimkait, T, Lauper, U, Opravil, M, Paccaud, F, Pantaleo, G, Perrin, L, Piffaretti, JC, Rickenbach, M, Rudin, C, Schüpbach, J, Speck, R, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Yerly, S, de Wolf, F, van Sighem, AI, van Valkengoed, I, Gras, L, Bronsveld, W, Veldkamp, A, Prins, JM, Bos, JC, Schattenkerk Eeftinck, JKM, Godfried, MH, Lange, JMA, Lowe, SH, van der Meer, JTM, Nellen, FJB, Pogany, K, van der Poll, T, Ruys, TA, Sankatsing, S, van der Valk, M, van Vonderen, MGA, Wit, FWMN, van Eeden, A, ten Veen, JH, van Dam, PS, Hillebrand-Haverkort, ME, Brinkman, K, Frissen, PHJ, Weigel, HM, Mulder, JW, van Gorp, ECM, Meenhorst, PL, Mairuhu, ATA, Veenstra, J, Danner, SA, Van Agtmael, MA, Claessen, FAP, Geerlings, SE, Perenboom, RM, Jurriaans, S, Back, NKT, Cuijpers, T, Rietra, PJGM, Roozendaal, KJ, Pauw, W, van Zanten, AP, Smits, PHM, von Blomberg, BME, Savelkoul, P, Zaaijer, H, Beijnen, JH, Crommentuyn, KML, Huitema, ADR, Kappelhoff, B, de Maat, MMR, Richter, C, van der Berg, J, van Leusen, R, Swanink, C, Vriesendorp, R, Jeurissen, FJF, Kauffmann, RH, Koger, ELW, Franck, PFH, Lampe, AS, Jansen, CL, Bravenboer, B, ten Napel, CHH, Mudrikova, T, Hendriks, R, Sprenger, HG, Miesen, WMAJ, Schirm, J, Benne, D, ten Kate, RW, Veenendaal, D, van Houte, DPF, Leemhuis, MP, Pole, M, Storm, H, van Zeijl, JH, Kroon, FP, Schippers, EF, Kroes, ACM, Claas, HCJ, Schreij, G, van de Geest, S, Verbon, A, Bruggeman, CAMVA, Goossens, VJ, Koopmans, PP, Telgt, M, van der Ven, AJAM, Burger, DM, Hugen, PWH, Galama, JMD, Poort, YAGM, van der Ende, ME, Gyssens, IC, de Marie, S, Nouwen, JL, Niesters, MG, Osterhaus, ADME, Schutten, M, Juttmann, JR, Buiting, AGM, Swaans, CAM, Schneider, MME, Bonten, MJM, Borleffs, JCC, Hoepelman, IM, Jaspers, CAJJ, Schouten, I, Schurink, CAM, Boucher, CAB, Schuurman, R, Blok, WL, Groeneveld, PHP, Boel, E, Jansz, AF, Dabis, F, Thiebaut, R, Chêne, G, Lawson-Ayayi, S, Meyer, L, Boufassa, F, Hamouda, O, Pezzotti, P, Rezza, G, Touloumi, G, Hatzakis, A, Karafoulidou, A, Katsarou, O, Brettle, R, Del Amo, J, del Romero, J, van Asten, L, van Benthem, B, Prins, M, Coutinho, R, Kirk, O, Pedersen, C, Hernández Aguado, I, Pérez-Hoyos, S, Eskild, A, Bruun, JN, Sannes, M, Lee, C, Johnson, AM, Babiker, A, Darbyshire, J, Gill, N, Porter, K, Francioli, P, Vanhems, P, Egger, M, Rickenbach, M, Cooper, D, Kaldor, J, Ashton, L, Cooper, D, Kaldor, J, Ashton, L, Vizzard, J, Muga, R, Vanhems, P, Gill, J, Cayla, J, Garcia de Olalla, P, Day, NE, De Angelis, D, Porter, K, Babiker, A, Walker, S, Darbyshire, J, Tyrer, F, Beral, V, Coutinho, R, Darbyshire, J, Del Amo, J, Gill, N, Lee, C, Meyer, L, Rezza, G, Raffanti, S, Becker, S, Scarsella, A, Braun, J, Most, B, Balu, R, Gilbert, L, Fleenor, R, Ising, T, Dieterich, D, Fusco, J, Losso, M, Bánhegyi, D, Vetter, N, Clumeck, N, De Wit, S, Kabeya, K, Poll, B, Colebunders, R, Machala, L, Rozsypal, H, Nielsen, J, Lundgren, J, Kirk, O, Olsen, CH, Gerstoft, J, Katzenstein, T, Hansen, ABE, Skinhøj, P, Pedersen, C, Zilmer, K, Rauka, M, Katlama, C, De Sa, M, Viard, JP, Saint-Marc, T, Vanhems, P, Pradier, C, Dietrich, M, Manegold, C, van Lunzen, J, Stellbrink, HJ, Miller, V, Goebel, FD, Salzberger, B, Rockstroh, J, Kosmidis, J, Gargalianos, P, Sambatakou, H, Perdios, J, Panos, G, Filandras, A, Banhegyi, D, Mulcahy, F, Yust, I, Burke, M, Pollack, S, Hassoun, J, Sthoeger, Z, Maayan, S, Vella, S, Chiesi, A, Arici, C, Pristerá, R, Mazzotta, F, Gabbuti, A, Esposito, R, Bedini, A, Chirianni, A, Montesarchio, E, Vullo, V, Santopadre, P, Narciso, P, Antinori, A, Franci, P, Zaccarelli, M, Lazzarin, A, Castagna, A, Viksna, L, Rozentale, B, Chaplinskas, S, Hemmer, R, Staub, T, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Prokopowicz, D, Wiercinska-Drapalo, A, Boron-Kaczmarska, A, Pynka, M, Beniowski, M, Trocha, H, Smiatacz, T, Antunes, F, Mansinho, K, Maltez, F, Duiculescu, D, Streinu-Cercel, A, Mokrás, M, Staneková, D, González-Lahoz, J, Diaz, B, García-Benayas, T, Martin-Carbonero, L, Soriano, V, Clotet, B, Jou, A, Conejero, J, Tural, C, Gatell, JM, Miró, JM, Zamora, L, Blaxhult, A, Karlsson, A, Pehrson, P, Francioli, P, Hirschel, B, Schiffer, V, Furrer, H, Chentsova, N, Barton, S, Johnson, AM, Mercey, D, Phillips, A, Youle, M, Johnson, MA, Mocroft, A, Murphy, M, Weber, J, Scullard, G, Fisher, M, Brettle, R, Loveday, C, Clotet, B, Ruiz, L, Helm, EB, Carlebach, A, Mösch, M, Müller, A, Haberl, A, Korn, S, Stephan, C, Bickel, M, Gute, P, Locher, L, Lutz, T, Klauke, S, Doerr, HW, Stürmer, M, Dauer, B, Jennings, B, Alexander, C, Braitstein, P, Chan, K, Cote, H, Gataric, N, Harrigan, PR, Harris, M, Bonner, S, Montaner, J, O'Shaughnessy, M, Wood, E, Yip, B, Chaloner, C, Gumley, H, Ransom, D, Sabin, CA, Mocroft, A, Lipman, M, Youle, M, Johnson, M, Gill, J, Read, R, Mazzotta, F, Riccio, G, Borghi, V, Bedini, A & Esposito, R 2004, 'Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes', The Lancet, vol. 364, no. 9428, pp. 51-62. https://doi.org/10.1016/S0140-6736(04)16589-6
Ledergerber, Bruno ; Lundgren, Jens D. ; Sarah Walker, A. ; Sabin, Caroline ; Justice, Amy ; Reiss, Peter ; Mussini, Cristina ; Wit, Ferdinand ; d'Arminio Monforte, Antonella ; Weber, Rainer ; Fusco, Gregory ; Staszewski, Schlomo ; Law, Matthew ; Hogg, Robert ; Lampe, Fiona ; John Gill, M. ; Castelli, Francesco ; Phillips, Andrew N. ; Rooney, P. ; Taylor, S. ; Couldwell, D. ; Austin, D. ; Block, M. ; Clemons, J. ; Finlayson, R. ; Petoumenos, K. ; Quan, D. ; Smith, D. ; O'Connor, C. ; Gorton, C. ; Allen, D. ; Mulhall, B. ; Mutimer, K. ; Keeffe, N. ; Cooper, D. ; Carr, A. ; Miller, J. ; Pell, C. ; Ellis, D. ; Baker, D. ; Kidd, J. ; McFarlane, R. ; Liang, M. T. ; Brown, K. ; Huffam, S. ; Savage, J. ; Morgan, S. ; Knibbs, P. ; Sowden, D. ; Walker, A. ; Orth, D. ; Lister, G. ; Chuah, J. ; Fankhauser, W. ; Dickson, B. ; Bradford, D. ; Wilson, C. ; Ree, H. ; Magon, H. ; Anderson, J. ; Moore, R. ; Russell, D. ; McGovern, G. ; McNair, R. ; Bal, J. ; Fairley, K. ; Roth, N. ; Eu, B. ; Strecker, S. ; Russell, D. ; Wood, H. ; Mijch, A. ; Hoy, J. ; Pierce, A. ; McCormack, C. ; Watson, K. ; Medland, N. ; Daye, J. ; Mallal, S. ; French, M. ; Skett, J. ; Maxwel, D. ; Cain, A. ; Montroni, M. ; Scalise, G. ; Costantini, A. ; Giacometti, A. ; Tirelli, U. ; Nasti, G. ; Pastore, G. ; Ladisa, N. ; Perulli, M. L. ; Pastore, G. ; Ladisa, N. ; Suter, F. ; Arici, C. ; Suter, F. ; Maggiolo, F. ; Chiodo, F. ; Gritti, F. M. ; Colangeli, V. ; Fiorini, C. ; Guerra, L. ; Carosi, G. ; Cadeo, G. P. ; Minardi, C. ; Vangi, D. ; Carosi, G. ; Paraninfo, G. ; Casari, S. ; Pan, A. ; Patroni, A. ; Torti, C. ; Quiros-Roldan, E. ; Tomasoni, L. ; Moretti, F. ; Nasta, P. ; Uccelli, M. C. ; Cadeo, G. P. ; Bertelli, D. ; Rizzardini, G. ; Migliorino, G. ; Rizzardini, G. ; Migliorino, M. ; Abeli, C. ; Manconi, P. E. ; Piano, P. ; Ferraro, T. ; Scerbo, A. ; Pizzigallo, E. ; Ricci, F. ; Santoro, D. ; Pusterla, L. ; Carnevale, G. ; Galloni, D. ; Carnevale, G. ; Viganò, P. ; Mena, M. ; Ghinelli, F. ; Sighinolfi, L. ; Ghinelli, F. ; Sighinolfi, L. ; Leoncini, F. ; Mazzotta, F. ; Pozzi, M. ; Lo Caputo, S. ; Angarano, G. ; Grisorio, B. ; Ferrara, S. ; Grima, P. ; Tundo, P. ; Pagano, G. ; Piersantelli, N. ; Alessandrini, A. ; Piscopo, R. ; Toti, M. ; Chigiotti, S. ; Soscia, F. ; Tacconi, L. ; Orani, A. ; Perini, P. ; Orani, A. ; Perini, P. ; Nigro, M. ; Scasso, A. ; Vincenti, A. ; Scalzini, A. ; Fibbia, G. ; Moroni, M. ; Lazzarin, A. ; Cargnel, A. ; Vigevani, G. M. ; Caggese, L. ; Tordato, F. ; Novati, R. ; Galli, A. ; Merli, S. ; Pastecchia, C. ; Moioli, C. ; Esposito, R. ; Abrescia, N. ; Chirianni, A. ; Izzo, C. ; Piazza, M. ; De Marco, M. ; Montesarchio, V. ; Manzillo, E. ; Nappa, S. ; Colomba, A. ; Abbadessa, V. ; Prestileo, T. ; Mancuso, S. ; Ferrari, C. ; Pzzaferri, P. ; Filice, G. ; Minoli, L. ; Bruno, R. ; Maserati, R. ; Minoli, L. ; Maserati, R. ; Novati, S. ; Tinelli, C. ; Pauluzzi, S. ; Baldelli, F. ; Petrelli, E. ; Cioppi, A. ; Alberici, F. ; Ruggieri, A. ; Menichetti, F. ; Martinelli, C. ; De Stefano, C. ; La Gala, A. ; Zauli, T. ; Ballardini, G. ; Magnani, G. ; Ursitti, M. A. ; Arlotti, M. ; Ortolani, P. ; Ortona, L. ; Dianzani, F. ; Ippolito, G. ; Antinori, A. ; Antonucci, G. ; D'Elia, S. ; Narciso, P. ; Petrosillo, N. ; Vullo, V. ; De Luca, A. ; Del Forno, L. ; Zaccarelli, M. ; De Longis, P. ; Ciardi, M. ; D'Offizi, G. ; Noto, P. ; Lichtner, M. ; Capobianchi, M. R. ; Girardi, E. ; Pezzotti, P. ; Rezza, G. ; Mura, M. S. ; Mannazzu, M. ; Caramello, P. ; Sinicco, A. ; Soranzo, M. L. ; Gennero, L. ; Sciandra, M. ; Salassa, B. ; Grossi, P. A. ; Basilico, C. ; Poggio, A. ; Bottari, G. ; Poggio, A. ; Raise, E. ; Pasquinucci, S. ; De Lalla, F. ; Tositti, G. ; Resta, F. ; Chimienti, A. ; Lepri Cozzi, A. ; Bachmann, S. ; Battegay, M. ; Bernasconi, E. ; Bucher, H. ; Bürgisser, P. ; Cattacin, S. ; Egger, M. ; Erb, P. ; Fierz, W. ; Fischer, M. ; Flepp, M. ; Fontana, A. ; Francioli, P. ; Furrer, H. J. ; Gorgievski, M. ; Günthard, H. ; Hirschel, B. ; Kaiser, L. ; Kind, C. ; Klimkait, T. ; Lauper, U. ; Opravil, M. ; Paccaud, F. ; Pantaleo, G. ; Perrin, L. ; Piffaretti, J. C. ; Rickenbach, M. ; Rudin, C. ; Schüpbach, J. ; Speck, R. ; Tarr, P. ; Telenti, A. ; Trkola, A. ; Vernazza, P. ; Yerly, S. ; de Wolf, F. ; van Sighem, A. I. ; van Valkengoed, I. ; Gras, L. ; Bronsveld, W. ; Veldkamp, A. ; Prins, J. M. ; Bos, J. C. ; Schattenkerk Eeftinck, J. K M ; Godfried, M. H. ; Lange, J. M A ; Lowe, S. H. ; van der Meer, J. T M ; Nellen, F. J B ; Pogany, K. ; van der Poll, T. ; Ruys, T. A. ; Sankatsing, S. ; van der Valk, M. ; van Vonderen, M. G A ; Wit, F. W M N ; van Eeden, A. ; ten Veen, J. H. ; van Dam, P. S. ; Hillebrand-Haverkort, M. E. ; Brinkman, K. ; Frissen, P. H J ; Weigel, H. M. ; Mulder, J. W. ; van Gorp, E. C M ; Meenhorst, P. L. ; Mairuhu, A. T A ; Veenstra, J. ; Danner, S. A. ; Van Agtmael, M. A. ; Claessen, F. A P ; Geerlings, S. E. ; Perenboom, R. M. ; Jurriaans, S. ; Back, N. K T ; Cuijpers, T. ; Rietra, P. J G M ; Roozendaal, K. J. ; Pauw, W. ; van Zanten, A. P. ; Smits, P. H M ; von Blomberg, B. M E ; Savelkoul, P. ; Zaaijer, H. ; Beijnen, J. H. ; Crommentuyn, K. M L ; Huitema, A. D R ; Kappelhoff, B. ; de Maat, M. M R ; Richter, C. ; van der Berg, J. ; van Leusen, R. ; Swanink, C. ; Vriesendorp, R. ; Jeurissen, F. J F ; Kauffmann, R. H. ; Koger, E. L W ; Franck, P. F H ; Lampe, A. S. ; Jansen, C. L. ; Bravenboer, B. ; ten Napel, C. H H ; Mudrikova, T. ; Hendriks, R. ; Sprenger, H. G. ; Miesen, W. M A J ; Schirm, J. ; Benne, D. ; ten Kate, R. W. ; Veenendaal, D. ; van Houte, D. P F ; Leemhuis, M. P. ; Pole, M. ; Storm, H. ; van Zeijl, J. H. ; Kroon, F. P. ; Schippers, E. F. ; Kroes, A. C M ; Claas, H. C J ; Schreij, G. ; van de Geest, S. ; Verbon, A. ; Bruggeman, C. A M V A ; Goossens, V. J. ; Koopmans, P. P. ; Telgt, M. ; van der Ven, A. J A M ; Burger, D. M. ; Hugen, P. W H ; Galama, J. M D ; Poort, Y. A G M ; van der Ende, M. E. ; Gyssens, I. C. ; de Marie, S. ; Nouwen, J. L. ; Niesters, M. G. ; Osterhaus, A. D M E ; Schutten, M. ; Juttmann, J. R. ; Buiting, A. G M ; Swaans, C. A M ; Schneider, M. M E ; Bonten, M. J M ; Borleffs, J. C C ; Hoepelman, I. M. ; Jaspers, C. A J J ; Schouten, I. ; Schurink, C. A M ; Boucher, C. A B ; Schuurman, R. ; Blok, W. L. ; Groeneveld, P. H P ; Boel, E. ; Jansz, A. F. ; Dabis, F. ; Thiebaut, R. ; Chêne, G. ; Lawson-Ayayi, S. ; Meyer, L. ; Boufassa, F. ; Hamouda, O. ; Pezzotti, P. ; Rezza, G. ; Touloumi, G. ; Hatzakis, A. ; Karafoulidou, A. ; Katsarou, O. ; Brettle, R. ; Del Amo, J. ; del Romero, J. ; van Asten, L. ; van Benthem, B. ; Prins, M. ; Coutinho, R. ; Kirk, O. ; Pedersen, C. ; Hernández Aguado, I. ; Pérez-Hoyos, S. ; Eskild, A. ; Bruun, J. N. ; Sannes, M. ; Lee, C. ; Johnson, A. M. ; Babiker, A. ; Darbyshire, J. ; Gill, N. ; Porter, K. ; Francioli, P. ; Vanhems, P. ; Egger, M. ; Rickenbach, M. ; Cooper, D. ; Kaldor, J. ; Ashton, L. ; Cooper, D. ; Kaldor, J. ; Ashton, L. ; Vizzard, J. ; Muga, R. ; Vanhems, P. ; Gill, J. ; Cayla, J. ; Garcia de Olalla, P. ; Day, N. E. ; De Angelis, D. ; Porter, K. ; Babiker, A. ; Walker, S. ; Darbyshire, J. ; Tyrer, F. ; Beral, V. ; Coutinho, R. ; Darbyshire, J. ; Del Amo, J. ; Gill, N. ; Lee, C. ; Meyer, L. ; Rezza, G. ; Raffanti, S. ; Becker, S. ; Scarsella, A. ; Braun, J. ; Most, B. ; Balu, R. ; Gilbert, L. ; Fleenor, R. ; Ising, T. ; Dieterich, D. ; Fusco, J. ; Losso, M. ; Bánhegyi, D. ; Vetter, N. ; Clumeck, N. ; De Wit, S. ; Kabeya, K. ; Poll, B. ; Colebunders, R. ; Machala, L. ; Rozsypal, H. ; Nielsen, J. ; Lundgren, J. ; Kirk, O. ; Olsen, C. H. ; Gerstoft, J. ; Katzenstein, T. ; Hansen, A. B E ; Skinhøj, P. ; Pedersen, C. ; Zilmer, K. ; Rauka, M. ; Katlama, C. ; De Sa, M. ; Viard, J. P. ; Saint-Marc, T. ; Vanhems, P. ; Pradier, C. ; Dietrich, M. ; Manegold, C. ; van Lunzen, J. ; Stellbrink, H. J. ; Miller, V. ; Goebel, F. D. ; Salzberger, B. ; Rockstroh, J. ; Kosmidis, J. ; Gargalianos, P. ; Sambatakou, H. ; Perdios, J. ; Panos, G. ; Filandras, A. ; Banhegyi, D. ; Mulcahy, F. ; Yust, I. ; Burke, M. ; Pollack, S. ; Hassoun, J. ; Sthoeger, Z. ; Maayan, S. ; Vella, S. ; Chiesi, A. ; Arici, C. ; Pristerá, R. ; Mazzotta, F. ; Gabbuti, A. ; Esposito, R. ; Bedini, A. ; Chirianni, A. ; Montesarchio, E. ; Vullo, V. ; Santopadre, P. ; Narciso, P. ; Antinori, A. ; Franci, P. ; Zaccarelli, M. ; Lazzarin, A. ; Castagna, A. ; Viksna, L. ; Rozentale, B. ; Chaplinskas, S. ; Hemmer, R. ; Staub, T. ; Bruun, J. ; Maeland, A. ; Ormaasen, V. ; Knysz, B. ; Gasiorowski, J. ; Horban, A. ; Prokopowicz, D. ; Wiercinska-Drapalo, A. ; Boron-Kaczmarska, A. ; Pynka, M. ; Beniowski, M. ; Trocha, H. ; Smiatacz, T. ; Antunes, F. ; Mansinho, K. ; Maltez, F. ; Duiculescu, D. ; Streinu-Cercel, A. ; Mokrás, M. ; Staneková, D. ; González-Lahoz, J. ; Diaz, B. ; García-Benayas, T. ; Martin-Carbonero, L. ; Soriano, V. ; Clotet, B. ; Jou, A. ; Conejero, J. ; Tural, C. ; Gatell, J. M. ; Miró, J. M. ; Zamora, L. ; Blaxhult, A. ; Karlsson, A. ; Pehrson, P. ; Francioli, P. ; Hirschel, B. ; Schiffer, V. ; Furrer, H. ; Chentsova, N. ; Barton, S. ; Johnson, A. M. ; Mercey, D. ; Phillips, A. ; Youle, M. ; Johnson, M. A. ; Mocroft, A. ; Murphy, M. ; Weber, J. ; Scullard, G. ; Fisher, M. ; Brettle, R. ; Loveday, C. ; Clotet, B. ; Ruiz, L. ; Helm, E. B. ; Carlebach, A. ; Mösch, M. ; Müller, A. ; Haberl, A. ; Korn, S. ; Stephan, C. ; Bickel, M. ; Gute, P. ; Locher, L. ; Lutz, T. ; Klauke, S. ; Doerr, H. W. ; Stürmer, M. ; Dauer, B. ; Jennings, B. ; Alexander, C. ; Braitstein, P. ; Chan, K. ; Cote, H. ; Gataric, N. ; Harrigan, P. R. ; Harris, M. ; Bonner, S. ; Montaner, J. ; O'Shaughnessy, M. ; Wood, E. ; Yip, B. ; Chaloner, C. ; Gumley, H. ; Ransom, D. ; Sabin, C. A. ; Mocroft, A. ; Lipman, M. ; Youle, M. ; Johnson, M. ; Gill, J. ; Read, R. ; Mazzotta, F. ; Riccio, G. ; Borghi, V. ; Bedini, A. ; Esposito, R. / Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes. In: The Lancet. 2004 ; Vol. 364, No. 9428. pp. 51-62.
@article{648530a734be4340af98b4066c55695b,
title = "Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes",
abstract = "Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure. Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models. Findings 2488 patients were included. 2118 (85{\%}) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5·5 per 100 person-years; 3-year mortality risk 15·3{\%} (95{\%} CI 13·5-17·3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15·8 (95{\%} CI 9·28-27·0) for counts below 50 cells per μL versus above 200 cells per μL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1·5 log 10 copies per mL below off-treatment values. Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per μL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1·5 log10 copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.",
author = "Bruno Ledergerber and Lundgren, {Jens D.} and {Sarah Walker}, A. and Caroline Sabin and Amy Justice and Peter Reiss and Cristina Mussini and Ferdinand Wit and {d'Arminio Monforte}, Antonella and Rainer Weber and Gregory Fusco and Schlomo Staszewski and Matthew Law and Robert Hogg and Fiona Lampe and {John Gill}, M. and Francesco Castelli and Phillips, {Andrew N.} and P. Rooney and S. Taylor and D. Couldwell and D. Austin and M. Block and J. Clemons and R. Finlayson and K. Petoumenos and D. Quan and D. Smith and C. O'Connor and C. Gorton and D. Allen and B. Mulhall and K. Mutimer and N. Keeffe and D. Cooper and A. Carr and J. Miller and C. Pell and D. Ellis and D. Baker and J. Kidd and R. McFarlane and Liang, {M. T.} and K. Brown and S. Huffam and J. Savage and S. Morgan and P. Knibbs and D. Sowden and A. Walker and D. Orth and G. Lister and J. Chuah and W. Fankhauser and B. Dickson and D. Bradford and C. Wilson and H. Ree and H. Magon and J. Anderson and R. Moore and D. Russell and G. McGovern and R. McNair and J. Bal and K. Fairley and N. Roth and B. Eu and S. Strecker and D. Russell and H. Wood and A. Mijch and J. Hoy and A. Pierce and C. McCormack and K. Watson and N. Medland and J. Daye and S. Mallal and M. French and J. Skett and D. Maxwel and A. Cain and M. Montroni and G. Scalise and A. Costantini and A. Giacometti and U. Tirelli and G. Nasti and G. Pastore and N. Ladisa and Perulli, {M. L.} and G. Pastore and N. Ladisa and F. Suter and C. Arici and F. Suter and F. Maggiolo and F. Chiodo and Gritti, {F. M.} and V. Colangeli and C. Fiorini and L. Guerra and G. Carosi and Cadeo, {G. P.} and C. Minardi and D. Vangi and G. Carosi and G. Paraninfo and S. Casari and A. Pan and A. Patroni and C. Torti and E. Quiros-Roldan and L. Tomasoni and F. Moretti and P. Nasta and Uccelli, {M. C.} and Cadeo, {G. P.} and D. Bertelli and G. Rizzardini and G. Migliorino and G. Rizzardini and M. Migliorino and C. Abeli and Manconi, {P. E.} and P. Piano and T. Ferraro and A. Scerbo and E. Pizzigallo and F. Ricci and D. Santoro and L. Pusterla and G. Carnevale and D. Galloni and G. Carnevale and P. Vigan{\`o} and M. Mena and F. Ghinelli and L. Sighinolfi and F. Ghinelli and L. Sighinolfi and F. Leoncini and F. Mazzotta and M. Pozzi and {Lo Caputo}, S. and G. Angarano and B. Grisorio and S. Ferrara and P. Grima and P. Tundo and G. Pagano and N. Piersantelli and A. Alessandrini and R. Piscopo and M. Toti and S. Chigiotti and F. Soscia and L. Tacconi and A. Orani and P. Perini and A. Orani and P. Perini and M. Nigro and A. Scasso and A. Vincenti and A. Scalzini and G. Fibbia and M. Moroni and A. Lazzarin and A. Cargnel and Vigevani, {G. M.} and L. Caggese and F. Tordato and R. Novati and A. Galli and S. Merli and C. Pastecchia and C. Moioli and R. Esposito and N. Abrescia and A. Chirianni and C. Izzo and M. Piazza and {De Marco}, M. and V. Montesarchio and E. Manzillo and S. Nappa and A. Colomba and V. Abbadessa and T. Prestileo and S. Mancuso and C. Ferrari and P. Pzzaferri and G. Filice and L. Minoli and R. Bruno and R. Maserati and L. Minoli and R. Maserati and S. Novati and C. Tinelli and S. Pauluzzi and F. Baldelli and E. Petrelli and A. Cioppi and F. Alberici and A. Ruggieri and F. Menichetti and C. Martinelli and {De Stefano}, C. and {La Gala}, A. and T. Zauli and G. Ballardini and G. Magnani and Ursitti, {M. A.} and M. Arlotti and P. Ortolani and L. Ortona and F. Dianzani and G. Ippolito and A. Antinori and G. Antonucci and S. D'Elia and P. Narciso and N. Petrosillo and V. Vullo and {De Luca}, A. and {Del Forno}, L. and M. Zaccarelli and {De Longis}, P. and M. Ciardi and G. D'Offizi and P. Noto and M. Lichtner and Capobianchi, {M. R.} and E. Girardi and P. Pezzotti and G. Rezza and Mura, {M. S.} and M. Mannazzu and P. Caramello and A. Sinicco and Soranzo, {M. L.} and L. Gennero and M. Sciandra and B. Salassa and Grossi, {P. A.} and C. Basilico and A. Poggio and G. Bottari and A. Poggio and E. Raise and S. 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A.} and S. Sankatsing and {van der Valk}, M. and {van Vonderen}, {M. G A} and Wit, {F. W M N} and {van Eeden}, A. and {ten Veen}, {J. H.} and {van Dam}, {P. S.} and Hillebrand-Haverkort, {M. E.} and K. Brinkman and Frissen, {P. H J} and Weigel, {H. M.} and Mulder, {J. W.} and {van Gorp}, {E. C M} and Meenhorst, {P. L.} and Mairuhu, {A. T A} and J. Veenstra and Danner, {S. A.} and {Van Agtmael}, {M. A.} and Claessen, {F. A P} and Geerlings, {S. E.} and Perenboom, {R. M.} and S. Jurriaans and Back, {N. K T} and T. Cuijpers and Rietra, {P. J G M} and Roozendaal, {K. J.} and W. Pauw and {van Zanten}, {A. P.} and Smits, {P. H M} and {von Blomberg}, {B. M E} and P. Savelkoul and H. Zaaijer and Beijnen, {J. H.} and Crommentuyn, {K. M L} and Huitema, {A. D R} and B. Kappelhoff and {de Maat}, {M. M R} and C. Richter and {van der Berg}, J. and {van Leusen}, R. and C. Swanink and R. Vriesendorp and Jeurissen, {F. J F} and Kauffmann, {R. H.} and Koger, {E. L W} and Franck, {P. F H} and Lampe, {A. S.} and Jansen, {C. L.} and B. Bravenboer and {ten Napel}, {C. H H} and T. Mudrikova and R. Hendriks and Sprenger, {H. G.} and Miesen, {W. M A J} and J. Schirm and D. Benne and {ten Kate}, {R. W.} and D. Veenendaal and {van Houte}, {D. P F} and Leemhuis, {M. P.} and M. Pole and H. Storm and {van Zeijl}, {J. H.} and Kroon, {F. P.} and Schippers, {E. F.} and Kroes, {A. C M} and Claas, {H. C J} and G. Schreij and {van de Geest}, S. and A. Verbon and Bruggeman, {C. A M V A} and Goossens, {V. J.} and Koopmans, {P. P.} and M. Telgt and {van der Ven}, {A. J A M} and Burger, {D. M.} and Hugen, {P. W H} and Galama, {J. M D} and Poort, {Y. A G M} and {van der Ende}, {M. E.} and Gyssens, {I. C.} and {de Marie}, S. and Nouwen, {J. L.} and Niesters, {M. G.} and Osterhaus, {A. D M E} and M. Schutten and Juttmann, {J. R.} and Buiting, {A. G M} and Swaans, {C. A M} and Schneider, {M. M E} and Bonten, {M. J M} and Borleffs, {J. C C} and Hoepelman, {I. M.} and Jaspers, {C. A J J} and I. Schouten and Schurink, {C. A M} and Boucher, {C. A B} and R. Schuurman and Blok, {W. L.} and Groeneveld, {P. H P} and E. Boel and Jansz, {A. F.} and F. Dabis and R. Thiebaut and G. Ch{\^e}ne and S. Lawson-Ayayi and L. Meyer and F. Boufassa and O. Hamouda and P. Pezzotti and G. Rezza and G. Touloumi and A. Hatzakis and A. Karafoulidou and O. Katsarou and R. Brettle and {Del Amo}, J. and {del Romero}, J. and {van Asten}, L. and {van Benthem}, B. and M. Prins and R. Coutinho and O. Kirk and C. Pedersen and {Hern{\'a}ndez Aguado}, I. and S. P{\'e}rez-Hoyos and A. Eskild and Bruun, {J. N.} and M. Sannes and C. Lee and Johnson, {A. M.} and A. Babiker and J. Darbyshire and N. Gill and K. Porter and P. Francioli and P. Vanhems and M. Egger and M. Rickenbach and D. Cooper and J. Kaldor and L. Ashton and D. Cooper and J. Kaldor and L. Ashton and J. Vizzard and R. Muga and P. Vanhems and J. Gill and J. Cayla and {Garcia de Olalla}, P. and Day, {N. E.} and {De Angelis}, D. and K. Porter and A. 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Filandras and D. Banhegyi and F. Mulcahy and I. Yust and M. Burke and S. Pollack and J. Hassoun and Z. Sthoeger and S. Maayan and S. Vella and A. Chiesi and C. Arici and R. Prister{\'a} and F. Mazzotta and A. Gabbuti and R. Esposito and A. Bedini and A. Chirianni and E. Montesarchio and V. Vullo and P. Santopadre and P. Narciso and A. Antinori and P. Franci and M. Zaccarelli and A. Lazzarin and A. Castagna and L. Viksna and B. Rozentale and S. Chaplinskas and R. Hemmer and T. Staub and J. Bruun and A. Maeland and V. Ormaasen and B. Knysz and J. Gasiorowski and A. Horban and D. Prokopowicz and A. Wiercinska-Drapalo and A. Boron-Kaczmarska and M. Pynka and M. Beniowski and H. Trocha and T. Smiatacz and F. Antunes and K. Mansinho and F. Maltez and D. Duiculescu and A. Streinu-Cercel and M. Mokr{\'a}s and D. Stanekov{\'a} and J. Gonz{\'a}lez-Lahoz and B. Diaz and T. Garc{\'i}a-Benayas and L. Martin-Carbonero and V. Soriano and B. Clotet and A. Jou and J. Conejero and C. Tural and Gatell, {J. M.} and Mir{\'o}, {J. M.} and L. Zamora and A. Blaxhult and A. Karlsson and P. Pehrson and P. Francioli and B. Hirschel and V. Schiffer and H. Furrer and N. Chentsova and S. Barton and Johnson, {A. M.} and D. Mercey and A. Phillips and M. Youle and Johnson, {M. A.} and A. Mocroft and M. Murphy and J. Weber and G. Scullard and M. Fisher and R. Brettle and C. Loveday and B. Clotet and L. Ruiz and Helm, {E. B.} and A. Carlebach and M. M{\"o}sch and A. M{\"u}ller and A. Haberl and S. Korn and C. Stephan and M. Bickel and P. Gute and L. Locher and T. Lutz and S. Klauke and Doerr, {H. W.} and M. St{\"u}rmer and B. Dauer and B. Jennings and C. Alexander and P. Braitstein and K. Chan and H. Cote and N. Gataric and Harrigan, {P. R.} and M. Harris and S. Bonner and J. Montaner and M. O'Shaughnessy and E. Wood and B. Yip and C. Chaloner and H. Gumley and D. Ransom and Sabin, {C. A.} and A. Mocroft and M. Lipman and M. Youle and M. Johnson and J. Gill and R. Read and F. Mazzotta and G. Riccio and V. Borghi and A. Bedini and R. Esposito",
year = "2004",
month = "7",
day = "3",
doi = "10.1016/S0140-6736(04)16589-6",
language = "English",
volume = "364",
pages = "51--62",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9428",

}

TY - JOUR

T1 - Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes

AU - Ledergerber, Bruno

AU - Lundgren, Jens D.

AU - Sarah Walker, A.

AU - Sabin, Caroline

AU - Justice, Amy

AU - Reiss, Peter

AU - Mussini, Cristina

AU - Wit, Ferdinand

AU - d'Arminio Monforte, Antonella

AU - Weber, Rainer

AU - Fusco, Gregory

AU - Staszewski, Schlomo

AU - Law, Matthew

AU - Hogg, Robert

AU - Lampe, Fiona

AU - John Gill, M.

AU - Castelli, Francesco

AU - Phillips, Andrew N.

AU - Rooney, P.

AU - Taylor, S.

AU - Couldwell, D.

AU - Austin, D.

AU - Block, M.

AU - Clemons, J.

AU - Finlayson, R.

AU - Petoumenos, K.

AU - Quan, D.

AU - Smith, D.

AU - O'Connor, C.

AU - Gorton, C.

AU - Allen, D.

AU - Mulhall, B.

AU - Mutimer, K.

AU - Keeffe, N.

AU - Cooper, D.

AU - Carr, A.

AU - Miller, J.

AU - Pell, C.

AU - Ellis, D.

AU - Baker, D.

AU - Kidd, J.

AU - McFarlane, R.

AU - Liang, M. T.

AU - Brown, K.

AU - Huffam, S.

AU - Savage, J.

AU - Morgan, S.

AU - Knibbs, P.

AU - Sowden, D.

AU - Walker, A.

AU - Orth, D.

AU - Lister, G.

AU - Chuah, J.

AU - Fankhauser, W.

AU - Dickson, B.

AU - Bradford, D.

AU - Wilson, C.

AU - Ree, H.

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PY - 2004/7/3

Y1 - 2004/7/3

N2 - Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure. Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models. Findings 2488 patients were included. 2118 (85%) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5·5 per 100 person-years; 3-year mortality risk 15·3% (95% CI 13·5-17·3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15·8 (95% CI 9·28-27·0) for counts below 50 cells per μL versus above 200 cells per μL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1·5 log 10 copies per mL below off-treatment values. Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per μL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1·5 log10 copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.

AB - Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure. Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models. Findings 2488 patients were included. 2118 (85%) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5·5 per 100 person-years; 3-year mortality risk 15·3% (95% CI 13·5-17·3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15·8 (95% CI 9·28-27·0) for counts below 50 cells per μL versus above 200 cells per μL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1·5 log 10 copies per mL below off-treatment values. Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per μL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1·5 log10 copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.

UR - http://www.scopus.com/inward/record.url?scp=3042740596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042740596&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(04)16589-6

DO - 10.1016/S0140-6736(04)16589-6

M3 - Article

C2 - 15234856

AN - SCOPUS:3042740596

VL - 364

SP - 51

EP - 62

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9428

ER -