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- Title
Markov modelling of HIV infection evolution in the HAART era.
- Authors
BINQUET, C.; LE TEUFF, G.; ABRAHAMOVICZ, M.; MAHBOUBI, A.; YAZDANPANAH, Y.; REY, D.; RABAUD, C.; CHIROUZE, C.; BERGER, J. L.; FALLER, J. P.; CHAVANET, P.; QUANTIN, C.; PIROTH, L.
- Abstract
The aim was to investigate the impact of the main prognostic factors on HIV evolution. A multi-state Markov model was applied in a cohort of 2126 patients to estimate impact of these factors on patients' clinical and immunological evolutions. Clinical progression and immunological deterioration shared most of their prognostic factors : male gender, intravenous drug use, weight loss, low haemoglobin level (<110 g/l), CD8 cell count (<500/mm³) and HIV viral load (>5 log10 copies/ml). Highly active retroviral therapy reduced the risks of clinical progression and immune deterioration whatever patients' CD4 cell count. Risk reductions were 41-60% for protease inhibitor-based and 27-68% for non-nucleoside reverse transcriptase inhibitor-based regimens. Three-year transition probabilities showed that only patients with a CD4 cell count ⩾350 CD4/mm³ could in most cases maintain their immunity. This model provides ' real life ' transition probabilities from one immunological stage to another, allowing decision analyses that could help determine the beneficial therapeutic strategies for HIV-infected patients.
- Subjects
HIV-positive persons; HIGHLY active antiretroviral therapy; HIV infections; DNA polymerases; BODY weight
- Publication
Epidemiology & Infection, 2009, Vol 137, Issue 9, p1272
- ISSN
0950-2688
- Publication type
Article
- DOI
10.1017/S0950268808001775