Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters

作者：M. Eugenia Socías, Omar Sued, Natalia Laufer, María Esther Lázaro, Horacio Mingrone, Daniel Pryluka, Carlos Remondegui, María Inés Figueroa, Carina César, Ana Gun, Gabriela Turk, María Belén Bouzas, Ravi Kavasery, Alejandro Krolewiecki, Hector Pérez, Horacio Salomón, Pedro Cahn, Grupo Argentino de Seroconversión Study Group · 发表于：Journal of the International AIDS Society · 年份：2011 · DOI：10.1186/1758-2652-14-40 · 被引用次数：56 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV-related health complications and treatments

BACKGROUND: Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial. METHODS: Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicentre registry of PHI-patients diagnosed between 1997 and 2008. Cox regression was used to analyze predictors of progression (LT-CD4 < 350 cells/mm3, B, C events or death) at 12 months among untreated patients. RESULTS: Among 134 subjects, 74% presented with acute retroviral syndrome (ARS). Seven opportunistic infections (one death), nine B events, and 10 non-AIDS defining serious events were observed. Among the 92 untreated patients, 24 (26%) progressed at 12 months versus three (7%) in the treated group (p = 0.01). The 12-month progression rate among untreated patients with ARS was 34% (95% CI 22.5-46.3) versus 13% (95% CI 1.1-24.7) in asymptomatic patients (p = 0.04). In univariate analysis, ARS, baseline LT-CD4 < 350 cells/mm3, and baseline and six-month viral load (VL) > 100,000 copies/mL were associated with progression. In multivariate analysis, only ARS and baseline VL > 100,000 copies/mL remained independently associated; HR: 8.44 (95% CI 0.97-73.42) and 9.44 (95% CI 1.38-64.68), respectively. CONCLUSIONS: In Argentina, PHI is associated with significant morbidity. HAART should be considered in PHI patients with ARS and high baseline VL to prevent diseas...