A decision tree to help determine the best timing and antiretroviral strategy in HIV-infected patients.

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Date publication

décembre 2011

Auteurs

Membres identifiés du Cancéropôle Est :
Pr BINQUET Christine, Pr QUANTIN Catherine


Tous les auteurs :
Piroth L, Fournel I, Mahy S, Yazdanpanah Y, Rey D, Rabaud C, Faller JP, Hoen B, Fardeheb M, Quantin C, Chavanet P, Binquet C

Résumé

Optimal antiretroviral strategies for HIV-infected patients still need to be established. To this end a decision tree including different antiretroviral strategies that could be adopted for HIV-infected patients was built. A 10-year follow-up was simulated by using transitional probabilities estimated from a large cohort using a time-homogeneous Markov model. The desired outcome was for patients to maintain a CD4 cell count of >500 cells/mm3 without experiencing AIDS or death. For patients with a baseline HIV viral load >/=5 log10 copies/ml, boosted protease inhibitor-based immediate highly active antiretroviral therapy (HAART) allowed them to spend 12% more time with CD4 >/=500/mm3 than did delayed HAART (6.40 vs. 5.69 and 5.57 vs. 4.90 years for baseline CD4 >/=500 and 350-499/mm3, respectively). In patients with a baseline HIV viral load /=500 and 350-499/mm3, respectively). Immediate HAART is beneficial in patients with a baseline HIV viral load 5 log10 copies/ml, whereas deferred HAART appears to be the best option for patients with CD4 >/=350/mm3 and baseline HIV viral load

Référence

Epidemiol Infect. 2011 Dec;139(12):1835-44