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- Title
Clinical course and quality of care in ART-naïve patients newly presenting in a HIV outpatient clinic.
- Authors
Platten, M.; Linnemann, R.; Kümmerle, T.; Jung, N.; Wyen, C.; Ehren, K.; Gravemann, S.; Gillor, D.; Cornely, O.; Fischer, J.; Lehmann, C.; Rockstroh, J.; Fätkenheuer, G.; Vehreschild, J.
- Abstract
Objectives: Little data exist about the quality of care for HIV-infected subjects in Germany. We investigated the clinical course of HIV-infected subjects newly presenting in our HIV outpatient clinic. Methods: Antiretroviral therapy (ART)-naïve HIV-infected subjects presenting between 2007 and 2008 were followed until June 2012. Clinical data and laboratory parameters were collected prospectively and analysed retrospectively. Results: From 281 subjects included, 34 patients (12 %) were lost to follow-up. 247 subjects remained, and 171 patients were followed for 1,497 days [1,121/1,726] (all data: median [interquartile range]). ART was started in 199 patients (81 %) 182 days [44/849] after HIV diagnosis, and all patients were treated according to European guidelines or within clinical trials. The CD4 cell count at first presentation was 320/µL [160/500] and declined to 210/µL [100/300] at ART start. 12 months thereafter, the CD4 cell count increased to 410/µL [230/545]. The HIV RNA was suppressed below 50 copies/mL after 108 days [63/173] in 182 patients (91 %). Initial ART was changed in 71 patients (36 %) after 281 days [99/718], in five patients (7 %) due to virological failure, in 66 patients (93 %) due to other reasons, e.g. side effects or patient's request. Conclusion: Two-thirds of the included patients were followed for more than 3 years, and ART was initiated in 81 % of the patients leading to complete virological suppression in most patients. Compliance of physicians with treatment guidelines was high. Late presentation with a severely compromised immune function remains a problem and impairs the otherwise good prognosis of HIV infection.
- Publication
Infection, 2014, Vol 42, Issue 5, p849
- ISSN
0300-8126
- Publication type
Journal Article
- DOI
10.1007/s15010-014-0646-9