Background
Methods
The IPEC clinical cohort
Study population and definitions
First-line ART effectiveness
Missing data
Immunologic response
Statistical analyses
Results
Study population
Total | 1311 | |
---|---|---|
Age
| ||
Mean (SD) | 37.1 (9.9) | |
< 30 | 355 (27.1) | |
30-39 | 446 (34.0) | |
≥ 40 | 510 (38.9) | |
Race
| ||
Non-white | 621 (47.4) | |
White | 690 (52.6) | |
Gender/Risk category
a
| ||
Women | 432 (33.0) | |
Heterosexual men | 327 (24.9) | |
MSM | 423 (32.3) | |
IDU/Other | 129 (9.8) | |
Years of formal education
| ||
< 4 | 277 (21.1) | |
4-8 | 380 (29.0) | |
> 8 | 654 (49.9) | |
Years since HIV + test
| ||
<= 3 | 836 (63.8) | |
> 3 | 475 (36.2) | |
Pre-treatment CD4 count/μL
b
| ||
Mean (SD) | 233 (184) | |
<= 200 | 494 (37.7) | |
201-350 | 392 (29.9) | |
> 350 | 208 (15.9) | |
Missing | 217 (16.6) | |
Pre-treatment HIV viral load copies/mL
c
| ||
<= 100000 | 532 (40.6) | |
> 100000 | 466 (35.5) | |
Missing | 313 (23.9) | |
Concurrent AIDS defining illness
d
| ||
No | 1013 (77.3) | |
Yes | 298 (22.7) | |
Hepatitis B/C co-infection
e
| ||
No | 1270 (96.9) | |
Yes | 41 (3.1) | |
ART regimen
f
| ||
PI-based | 324 (24.7) | |
NNRTI-based | 987 (75.3) | |
Calendar year of ART initiation
| ||
2000-2004 | 392 (29.9) | |
2005-2009 | 919 (70.1) | |
Started ART in clinical trial
| ||
No | 856 (65.3) | |
Yes | 455 (34.7) |
First-line ART effectiveness
6 months | 12 months | 24 months | ||
---|---|---|---|---|
Overall | N (%) | N (%) | N (%) | |
For patients with HIV VL | 754/980 (76.9) | 802/1054 (76.1) | 637/938 (67.9) | |
Best-case scenarioa | 1085/1311 (82.8) | 1059/1311 (80.8) | 1010/1311 (77.0) | |
Worst-case scenariob | 754/1311 (57.5) | 802/1311 (61.2) | 637/1311 (48.6) | |
Stratified by type of ART regimen
| ||||
NNRTI-based
| ||||
For patients with HIV VL | 583/740 (78.8) | 603/784 (76.9) | 503/711 (70.7) | |
Best-case scenario | 830/987 (84.1) | 806/987 (81.7) | 779/987 (78.9) | |
Worst-case scenario | 583/987 (59.1) | 603/987 (61.1) | 503/987 (51.0) | |
PI-based
| ||||
For patients with HIV VL | 171/240 (71.3) | 199/270 (73.7) | 134/227 (59.0) | |
Best-case scenario | 255/324 (78.7) | 253/324 (78.1) | 231/324 (71.3) | |
Worst-case scenario | 171/324 (52.8) | 199/324 (61.4) | 134/324 (41.4) | |
Stratified by calendar year of ART initiation
| ||||
2000-2004
| ||||
For patients with HIV VL | 157/252 (62.3) | 188/297 (63.3) | 171/287 (59.6) | |
Best-case scenario | 297/392 (75.8) | 283/392 (72.2) | 276/392 (70.4) | |
Worst-case scenario | 157/392 (40.1) | 188/392 (48.0) | 171/392 (43.6) | |
2005-2010
| ||||
For patients with HIV VL | 597/728 (82.0) | 614/757 (81.1) | 466/651 (71.6) | |
Best-case scenario | 788/919 (85.7) | 776/919 (84.4) | 734/919 (79.9) | |
Worst-case scenario | 597/919 (65.0) | 614/919 (66.8) | 466/919 (50.7) |
CD4 counts
Factors associated with virologic suppression
12 months | 24 months | ||||
---|---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | ||
RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) | ||
Age
| |||||
< 30 | Ref. | Ref. | Ref. | ||
30-39 | 0.99 (0.91, 1.08) | 1.05 (0.93, 1.18) | 1.06 (0.94, 1.19) | ||
> = 40 | 1.04 (0.95, 1.13) | 1.09 (0.98, 1.22) |
1.12 (1.00, 1.26)
| ||
Race
| |||||
Non-white | Ref. | Ref. | |||
White |
1.07 (1.00, 1.14)
| 1.05 (0.97, 1.15) | |||
Gender/Risk category
a
| |||||
Women |
0.89 (0.82, 0.98)
|
0.90 (0.82, 0.99)
| 0.92 (0.82, 1.03) | 0.94 (0.84, 1.06) | |
Heterosexual men | Ref. | Ref. | Ref. | Ref. | |
MSM | 1.05 (0.97, 1.15) | 1.02 (0.93, 1.12) | 1.11 (0.99, 1.25) | 1.11 (0.98, 1.25) | |
IDU/Other | 1.02 (0.90, 1.16) | 1.02 (0.89, 1.16) | 0.93 (0.78, 1.11) | 0.95 (0.79, 1.13) | |
Education
| |||||
< 4 years | Ref. | Ref. | Ref. | Ref. | |
4-8 years | 1.06 (0.96, 1.17) | 1.07 (0.96, 1.18) | 1.12 (0.98, 1.28) | 1.13 (0.99, 1.29) | |
> 8 years |
1.16 (1.06, 1.27)
|
1.13 (1.03, 1.24)
|
1.17 (1.04, 1.32)
|
1.14 (1.00, 1.29)
| |
Years since HIV + test
| |||||
<= 3 | Ref. | Ref. | |||
> 3 | 0.97 (0.90, 1.04) | 0.94 (0.86, 1.03) | |||
Baseline CD4 cell count
b
| |||||
<= 200 | Ref. | Ref. | |||
201-350 | 1.05 (0.97, 1.14) | 1.01 (0.91, 1.12) | |||
> 350 | 1.09 (0.99, 1.20) | 1.11 (0.97, 1.26) | |||
Missing | 0.92 (0.83, 1.03) | 1.01 (0.88, 1.15) | |||
Baseline HIV viral load
c
| |||||
<= 100000 | Ref. | Ref. | |||
> 100000 | 1.00 (0.93, 1.08) | 1.03 (0.93, 1.14) | |||
Missing | 0.95 (0.87, 1.04) | 0.99 (0.88, 1.11) | |||
Concurrent ADI
d
| |||||
No | Ref. | Ref. | |||
Yes | 1.06 (0.98, 1.16) | 1.06 (0.95, 1.18) | |||
Hepatitis B/C co-infection
e
| |||||
No | Ref. | Ref. | |||
Yes | 1.16 (0.95, 1.43) | 1.07 (0.83, 1.39) | |||
Initial ART regimen
f
| |||||
PI-based | Ref. | Ref. | Ref. | ||
NNRTI-based | 1.04 (0.96, 1.13) |
1.20 (1.08, 1.34)
|
1.17 (1.05, 1.31)
| ||
Calendar year of ART initiation
| |||||
2005-2010 |
1.28 (1.18, 1.39)
|
1.25 (1.15, 1.35)
|
1.20 (1.09, 1.33)
|
1.14 (1.03, 1.27)
| |
2000-2004 | Ref. | Ref. | Ref. | Ref. | |
Started ART in clinical trial
| |||||
No | Ref. | Ref. | Ref. | Ref. | |
Yes |
1.10 (1.03, 1.18)
|
1.08 (1.01, 1.16)
|
1.14 (1.04, 1.25)
|
1.12 (1.02, 1.23)
|
12 months | 24 months | ||||||
---|---|---|---|---|---|---|---|
RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) | ||
Missing excluded | Missing = Success | Missing = Failure | Missing excluded | Missing = Success | Missing = Failure | ||
Age
| |||||||
< 30 | Ref. | Ref. | Ref. | ||||
30-39 | 1.06 (0.94, 1.19) | 1.01 (0.94, 1.09) | 1.15 (0.99, 1.33) | ||||
> = 40 | 1.12 (1.00, 1.26) | 1.04 (0.97, 1.13) | 1.24 (1.07, 1.44) | ||||
Gender/Risk category
| |||||||
Women | 0.90 (0.82, 0.99) | 0.93 (0.87, 1.00) | 0.87 (0.77, 0.98) | 0.94 (0.84, 1.06) | 0.94 (0.87, 1.02) | 0.98 (0.84, 1.14) | |
Heterosexual men | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | |
MSM | 1.02 (0.93, 1.12) | 1.03 (0.96, 1.11) | 0.98 (0.87, 1.10) | 1.11 (0.98, 1.25) | 1.08 (0.99, 1.17) | 1.05 (0.90, 1.22) | |
IDU/Other | 1.02 (0.89, 1.16) | 1.03 (0.94, 1.14) | 0.89 (0.75, 1.05) | 0.95 (0.79, 1.13) | 0.97 (0.87, 1.09) | 0.87 (0.70, 1.09) | |
Education
| |||||||
< 4 years | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | |
4-8 years | 1.07 (0.96, 1.18) | 1.05 (0.97, 1.13) | 1.05 (0.93, 1.20) | 1.13 (0.99, 1.29) | 1.06 (0.98, 1.16) | 1.18 (1.00, 1.39) | |
> 8 years | 1.13 (1.03, 1.24) | 1.08 (1.01, 1.17) | 1.16 (1.03, 1.30) | 1.14 (1.00, 1.29) | 1.07 (0.99, 1.16) | 1.21 (1.03, 1.41) | |
Initial ART regimen
| |||||||
PI-based | Ref. | Ref. | Ref. | ||||
NNRTI-based | 1.17 (1.05, 1.31) | 1.09 (1.02, 1.17) | 1.21 (1.05, 1.39) | ||||
Calendar year of ART initiation
| |||||||
2005-2009 | 1.25 (1.15, 1.35) | 1.14 (1.08, 1.22) | 1.34 (1.21, 1.49) | 1.14 (1.03, 1.27) | 1.11 (1.03, 1.19) | 1.08 (0.95, 1.23) | |
2000-2004 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | |
Started ART in clinical trial
| |||||||
No | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | |
Yes | 1.08 (1.01, 1.16) | 1.05 (0.99, 1.11) | 1.10 (1.00, 1.21) | 1.12 (1.02, 1.23) | 1.04 (0.98, 1.11) | 1.24 (1.10, 1.39) |