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• W1990996711 abstract "Objective: To examine the implications of early virologic response to highly active antiretroviral therapy (HAART) on long-term HAART utilization patterns, development of diabetes or hyperlipidemia, and mortality in an urban HIV-1 clinic. Design: A cohort of 444 patients in an urban HIV-1 clinic, who started HAART prior to January 1, 1999, were categorized by virologic response in the first 18 months of therapy: durable viral suppression, initial suppression followed by rebound, and failure to achieve suppression. Antiretroviral exposure, HIV-1 RNA levels, CD4 cell counts, development of diabetes or hyperlipidemia, and survival were compared in the three groups. Results: Over 4 years of follow-up, patients in the durable suppression group used HAART 82% of the time compared with 60% in the rebound group (p < .001) and 23% in the failure to suppress group (p < .001). Through 4 years of follow-up, patients in the rebound group had a cumulative exposure to a median of seven antiretroviral drugs (interquartile range [IQR]: 6-9) compared with five drugs in the durable suppression group (IQR: 4-6) and five drugs in the failure to suppress group (IQR: 3-7) (p < .001 for both comparisons with the rebound group). At 5 years, the estimated proportions surviving were 89% in the durable suppression group, 76% in the rebound group (p = .04), and 56% in the failure to suppress group (p < .001). During follow-up, 35% in the durable suppression group developed diabetes or hyperlipidemia compared with 24% in the rebound group (p = .15) and 8% in the failure to suppress group (p < .001). Conclusions: This study highlights the long-term implications of early virologic response to HAART for survival, accumulation of triple-class antiretroviral exposure, and development of HAART-associated toxicities." @default.
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• W1990996711 date "2003-07-01" @default.
• W1990996711 modified "2023-10-12" @default.
• W1990996711 title "Survival in an Urban HIV-1 Clinic in the Era of Highly Active Antiretroviral Therapy: A 5-Year Cohort Study" @default.
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• W1990996711 doi "https://doi.org/10.1097/00126334-200307010-00005" @default.
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