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Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data From the PRESTIGIO Registry

2020; Oxford University Press; Volume: 7; Issue: 11 Linguagem: Inglês

10.1093/ofid/ofaa456

2328-8957

Laura Galli, Maria Rita Parisi, Andrea Poli, Marianna Menozzi, Marta Fiscon, Elisa Garlassi, Daniela Francisci, Antonio Di Biagio, Gaetana Sterrantino, Chiara Fornabaio, Anna Degli Antoni, Gioacchino Angarano, Francesco Maria Fusco, Antonella d’Arminio Monforte, Giulio Maria Corbelli, Maria Mercedes Santoro, Maurizio Zazzi, Antonella Castagna, Antonella Castagna, Nicola Gianotti, Laura Galli, Franco Maggiolo, Leonardo Calza, Emanuele Focà, Gaetana Sterrantino, Giovanni Cenderello, Antonio Di Biagio, Stefano Rusconi, Cristina Mussini, Marianna Menozzi, Andrea Antinori, Roberta Gagliardini, Stefano Bonora, Sergio Ferrara, Maurizio Zazzi, Maria Mercedes Santoro, Giulio Maria Corbelli, Maurizio Zazzi, Maria Mercedes Santoro, Andrea Galli, Elisabetta Carini, Maria Rita Parisi, Laura Galli, Andrea Poli, Alba Bigoloni, Marcello Tavio, Luca Butini, Andrea Giacometti, Emanuela Vaccher, Ferdinando Martellotta, Valentina Da Ros, Gioacchino Angarano, Annalisa Saracino, Flavia Balena, Franco Maggiolo, Laura Comi, Elisa Di Filippo, Daniela Valenti, Claudia Suardi, Barbara Mazzola, Pierluigi Viale, Leonardo Calza, Elena Rosselli Del Turco, Marta Vacas Ramirez, Francesco Castelli, Emanuele Focà, Anna Celotti, Francesca Brognoli, G. Bonoldi, Barbara Menzaghi, C Abeli, Maddalena Farinazzo, Francesco Perna, Marco Campus, Bruno Cacopardo, Benedetto Maurizio Celesia, Angelo Pan, Chiara Fornabaio, Alessandro Bartoloni, Gaetana Sterrantino, Francesca Rinaldi, Susanna Giachè, Blanc Pierluigi, Francesca Vichi, Francesco Maria Fusco, Teresa Santantonio, Sergio Ferrara, Serena Rita Bruno, Giovanni Cassola, Giovanni Cenderello, Marcello Feasi, Francesca Calautti, Matteo Bassetti, Antonio Di Biagio, Bianca Bruzzone, Stefania Artioli, Adriano Lazzarin, Antonella Castagna, Nicola Gianotti, Elisabetta Carini, Maria Rita Parisi, Laura Galli, Andrea Poli, Andrea Galli, Diana Canetti, Massimo Galli, Stefano Rusconi, Tiziana Formenti, Valentina Morena, Arianna Gabrieli, Antonella d’Arminio Monforte, Lidia Gazzola, Esther Merlini, Valentina Minieri, Andrea Gori, Alessandra Bandera, Valeria Pastore, Valentina Ferroni, Massimo Puoti, Cristina Moioli, Sara Vassalli, Cristina Mussini, Marianna Menozzi, Enrica Roncaglia, Giulia Nardini, Barbara Beghetto, Elio Manzillo, Alfredo Franco‐Obregón, Anna Maria Cattelan, Serena Marinello, Silvia Cavinato, Annamaria Macario, Antonio Cascio, Giovanni Mazzola, Anna Maria Degli Antoni, Carlo Ferrari, Diletta Laccabue, G. Filice, Roberto Gulminetti, Layla Pagnucco, Annalia Asti, Daniela Francisci, Elisabetta Schiaroli, Chiara Papalini, Francesca Italiani, Massimo Di Pietro, G. Magnani, Elisa Garlassi, Enrico Barchi, Romina Corsini, Andrea Antinori, Roberta Gagliardini, Alessandra Vergori, Stefania Cicalini, Giovanna Onnelli, Alberto Giannetti, Roberto Cauda, Arturo Ciccullo, Silvia La Monica, Vincenzo Vullo, Gabriella d’Ettorre, Eugenio Nelson Cavallari, Massimo Andreoni, Vincenzo Malagnino, Laura Ceccarelli, Filippo Viviani, Lolita Sasset, Chiara Dentone, Barbara Rossetti, Sara Modica, Valentina Borgo, Giovanni Di Perri, Stefano Bonora, Sergio Ferrara, Chiara Carcieri, Marina Malena, Marta Fiscon, Barbara Padovani, Roberto Luzzati, Sandro Centonze, Romina Valentinotti,

HIV Research and Treatment

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.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.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).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.