Portal de Periódicos da CAPES

AIDS-defining events among people living with HIV who have been under continuous antiretroviral therapy for more than one year, a German cohort study 1999–2018

2024; Springer Science+Business Media; Volume: 52; Issue: 2 Linguagem: Inglês

10.1007/s15010-024-02188-y

1439-0973

Annemarie Pantke, Christian Kollan, Barbara Gunsenheimer‐Bartmeyer, Björn‐Erik Ole Jensen, Christoph Stephan, Olaf Degen, Dirk Schürmann, Tobias Kurth, Viviane Bremer, Uwe Koppe, Heribert Knechten, Petra Panstruga, Keikawus Arastéh, Michael Rittweger, Hans Wesselmann, Nikolai Menner, Ulrich Bohr, Heiko Jessen, Arne Jessen, Hubert Schulbin, Sascha Brand, Jan Gumprecht, Beate Weninger, Heribert Hillenbrand, Heiko Karcher, Klaus Fischer, Dietmar Schranz, M. Vallée, Jukka Hartikainen, Stephan Grunwald, Jörg Claus, Claudia Thomas, Roland Grimm, Sarah Schoor, Christiane Cordes, Reinhold Schrøder, Tobias Glaunsinger, Michael Rausch, Thomas Reineke, Gordon Weinberg, Manuel Bruhy, Siegfried Köppe, Peter Kreckel, Andreas Berger, Sinah Lindemann, Norbert H. Brockmeyer, Anja Potthoff, Kathrin van Bremen, Jürgen K. Rockstroh, Martin Hower, Claudia Bachmann, Petra Spornraft‐Ragaller, Dieter Teichmann, Björn‐Erik Ole Jensen, Falk Hüttig, Stefan Eßer, Pia Schenk-Westkamp, Annette Haberl, Christoph Stephan, Susanne Usadel, Matthias C. Müller, Janina Trauth, Alan Chavez-Valladares, G. Deutschinoff, Burkhard Kreft, Danica Lange, Olaf Degen, Guido Schäfer, Andreas Plettenberg, Frieder Kuhlendahl, Dorothea Wiemer, Lavinia Biemann, Knud Schewe, Christian Hoffmann, Georg M. N. Behrens, Matthias Stoll, Benjamin T. Schleenvoigt, Mathias W. Pletz, Ansgar Rieke, Stephan Schneeweiß, Stefan Scholten, Mark Oette, Peter A. Arbter, Thomas Grünewald, J Weidemann, Ines Ruck, Bernd Claus, Martin F. Sprinzl, Peter R. Galle, Matthias P. Ebert, Roger Vogelmann, Johannes R. Bogner, Ulrike Hellerer, Antonia Todorova, Claudia Traidl‐Hoffmann, Birgit Mück, Ramona Pauli, Christoph D. Spinner, Jochen Schneider, Birgit Mück, Robert Baumann, Niels Schübel, Christiane Berning, Franz Audebert, Andreas Trein, Eiko Schnaitmann, Clemens Roll, Simone Marquardt, Georg Härter, Beate Grüner, Cengiz Güler, Steve Rößler, Dirk Schürmann, Marianne Warncke, Jürgen K. Rockstroh, Jan‐Christian Wasmuth, Svetlana Hass, Björn‐Erik Ole Jensen, Cecilie Feind, Stefan Eßer, Pia Schenk-Westkamp, Christoph Stephan, Annette Haberl, Peter K. Schott, Andreas Plettenberg, Thore Lorenzen, Frieder Kuhlendahl, Axel Adam, Thomas Buhk, Stephan Fenske, Stefan Hansen, Christian Hoffmann, Michael Sabranski, Knud Schewe, Hans‐Jürgen Stellbrink, Dennis Radzuweit, Alexander Mainka, Constantin Rickassel, Olaf Degen, Guido Schäfer, Robin Scheiter, Matthias Stoll, S. Gerschmann, Renate Beider, Heinz‐August Horst, Silke Trautmann, Gerd Fätkenheuer, Jörg Janne Vehreschild, Laura Hamacher, Lennart Nicksch, Johannes R. Bogner, Barbara Sonntag, Oliver Pullen, Carlos Fritzsche,

Pneumocystis jirovecii pneumonia detection and treatment

Abstract Purpose This study examined the characteristics, incidence and prognostic factors of the first AIDS-defining condition developed after more than one year of continuous antiretroviral therapy (ART) among people living with HIV (PLHIV). Methods We used data from two multicentre observational cohorts of PLHIV in Germany between 1999 and 2018. Our outcome was the first AIDS-defining event that occurred during follow-up after more than one year of continuous ART. Descriptive analyses at ART initiation, at the time of the AIDS event and of the most frequently observed types of AIDS-defining illnesses were performed. We calculated the incidence rate (IR) per 1000 person-years (PY) and used a bootstrap stepwise selection procedure to identify predictors of the outcome. Results A total of 12,466 PLHIV were included in the analyses. 378 developed the outcome, constituting an overall IR of 5.6 (95% CI 5.1–6.2) AIDS events per 1000 PY. The majority of PLHIV was virally suppressed at the time of the event. Oesophageal candidiasis and wasting syndrome were the most frequently diagnosed AIDS-defining illnesses. We found a low CD4 count at ART initiation, a previous AIDS-defining condition and transmission through intravenous drug use to be meaningful prognostic factors of the outcome. Conclusion The overall rate of AIDS-defining events among PLHIV under long-term ART was low, highlighting the importance of continuous treatment. PLHIV who started ART with indicators of impaired immune functioning were more susceptible to disease progression, suggesting that the public health response should continue to focus on early and sustained treatment for all PLHIV.