Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data from the PRESTIGIO Registry
Articolo
Data di Pubblicazione:
2020
Abstract:
Background: Currently, no data are available on the burden of morbidity and mortality in people with HIV-1 (PWH) harboring a 4-class drug-resistant (4DR) virus (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase strand transfer inhibitors). The study aimed to assess the incidence of clinical events and death in this population. Methods: This was a cohort study on PWH from the PRESTIGIO Registry with a documented 4DR virus. Burden of disease was defined as the occurrence of any new event including an AIDS-defining event (ADE) or non-AIDS-defining event (NADE) or death from any cause after 4DR evidence (baseline). Cox regression models evaluated factors associated with the risk of new clinical events/death. Results: Among 148 PWH followed for a median (interquartile range) of 47 (32-84) months after 4DR evidence, 38 PWH had 62 new events or died from any cause (incidence rate, 9.12/100 person-years of follow-up; 95% CI = 6.85-11.39): 12 deaths (6 AIDS-related and 6 non-AIDS-related), 18 ADEs, 32 NADEs; 20 of the 38 NADEs (45%) of the incident clinical events were malignancies. The 4-year cumulative incidence of death was 6% (95% CI, 3%-13%), and that of ≥1 event or death was 22% (95% CI, 16%-31%). A higher risk of new clinical events/death was more likely in PWH with previous clinical events (adjusted hazard ratio [aHR], 2.67; 95% CI, 1.07-6.67) and marginally associated with lower baseline CD4+/CD8+ ratio (aHR, 0.82; 95% CI, 0.65-1.02). Conclusions: PWH harboring 4DR have a high burden of disease with a worrying incidence of malignancies, strongly advising for close prevention and monitoring interventions as well as access to innovative therapeutic strategies, especially in people with a history of clinical events and low CD4+/CD8+ ratio.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
4-class drug resistance; AIDS-defining event; cancer; death; non-AIDS-defining event
Elenco autori:
Galli, L.; Parisi, M. R.; Poli, A.; Menozzi, M.; Fiscon, M.; Garlassi, E.; Francisci, D.; DI Biagio, A.; Sterrantino, G.; Fornabaio, C.; Degli Antoni, A.; Angarano, G.; Fusco, F. M.; D'Arminio Monforte, A.; Corbelli, G. M.; Santoro, M. M.; Zazzi, M.; Castagna, A.; Castagna, A.; Gianotti, N.; Galli, L.; Maggiolo, F.; Calza, L.; Foca', E.; Sterrantino, G.; Cenderello, G.; DI Biagio, A.; Rusconi, S.; Mussini, C.; Menozzi, M.; Antinori, A.; Gagliardini, R.; Bonora, S.; Ferrara, M.; Zazzi, M.; Santoro, M.; Corbelli, G. M.; Zazzi, M.; Santoro, M. M.; Galli, A.; Carini, E.; Parisi, M. R.; Galli, L.; Poli, A.; Bigoloni, A.; Tavio, M.; Butini, L.; Giacometti, A.; Vaccher, E.; Martellotta, F.; Da Ros, V.; Angarano, G.; Saracino, A.; Balena, F.; Maggiolo, F.; Comi, L.; DI Filippo, E.; Valenti, D.; Suardi, C.; Mazzola, B.; Viale, P.; Calza, L.; Del Turco, E. R.; Ramirez, M. V.; Castelli, F.; Foca', E.; Celotti, A.; Brognoli, F.; Bonoldi, G.; Menzaghi, B.; Abeli, C.; Farinazzo, M.; Ortu, F.; Campus, M.; Cacopardo, B.; Celesia, M.; Pan, A.; Fornabaio, C.; Bartoloni, A.; Sterrantino, G.; Rinaldi, F.; Giache, S.; Pierluigi, B.; Vichi, F.; Fusco, F. M.; Santantonio, T.; Ferrara, S.; Bruno, S. R.; Cassola, G.; Cenderello, G.; Marcello, F.; Calautti, F.; Bassetti, M.; DI Biagio, A.; Bruzzone, B.; Artioli, S.; Lazzarin, A.; Castagna, A.; Gianotti, N.; Carini, E.; Parisi, M. R.; Galli, L.; Poli, A.; Galli, A.; Canetti, D.; Galli, M.; Rusconi, S.; Formenti, T.; Morena, V.; Gabrieli, A.; D'Arminio Monforte, A.; Gazzola, L.; Merlini, E.; Minieri, V.; Gori, A.; Bandera, A.; Pastore, V.; Ferroni, V.; Puoti, M.; Moioli, C.; Vassalli, S.; Mussini, C.; Menozzi, M.; Enrica, R.; Giulia, N.; Beghetto, B.; Manzillo, E.; Franco, A.; Cattelan, A. M.; Marinello, S.; Cavinato, S.; Macario, A.; Cascio, A.; Mazzola, G.; Antoni, A. M. D.; Ferrari, C.; Laccabue, D.; Filice, G.; Gulminetti, R.; Pagnucco, L.; Asti, A.; Francisci, D.; Schiaroli, E.; Papalini, C.; Italiani, F.; DI Pietro, M.; Magnani, G.; Elisa, G.; Barchi, E.; Corsini, R.; Antinori, A.; Gagliardini, R.; Vergori, A.; Cicalini, S.; Onnelli, G.; Giannetti, A.; Cauda, R.; Ciccullo, A.; La Monica, S.; Vullo, V.; Dettorre, G.; Cavallari, E. N.; Andreoni, M.; Malagnino, V.; Ceccarelli, L.; Viviani, F.; Sasset, L.; Dentone, C.; Rossetti, B.; Modica, S.; Borgo, V.; DI Perri, G.; Bonora, S.; Ferrara, M.; Carcieri, C.; Malena, M.; Fiscon, M.; Padovani, B.; Luzzati, R.; Centonze, S.; Valentinotti, R.
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