EuroSIDA研究におけるエイズと死亡率の減少:観察研究
A Mocroft1, B Ledergerber, C Katlama
1Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. a.mocroft@pcps.ucl.ac.uk
Lancet (London, England)
|July 11, 2003
まとめ
高活性抗レトロウイルス療法 (HAART) の持続的な有効性は,ヨーロッパ全土でHIV-1による死亡率とエイズによる死亡率を著しく低下させました. これらのポジティブな結果は,HAARTを証明しています.
科学分野:
- 免疫学 免疫学とは
- ウイルス学 ウイルス学 ウイルス学
- エピデミオロジー エピデミオロジー
背景:
- 高活性抗レトロウイルス療法 (HAART) がHIV-1の死亡率と発症率に及ぼす長期的な影響については,現在も調査中です.
- これらの割合の持続的な変化を評価することは,HAARTの継続的な有効性を理解するために重要である.
研究 の 目的:
- HAARTの導入後のヨーロッパ全土のHIV-1死亡率と発症率の持続的な変化を評価する.
- 患者のアウトカムに対する異なる治療期間の影響を分析する.
主な方法:
- イスラエルとアルゼンチンを含む70の欧州HIVセンターの9,803人の患者のデータを分析した.
- CD4 カウンターと治療時代 (前ハート,早期ハート,後期ハート) に基づいて,エイズや死亡の発生率の計算.
- 多変量コックスモデルを使用して,異なる治療期間に関連するリスクを評価しました.
主要な成果:
- 1998年9月以降,エイズや死亡率の有意な減少が観察されました (6ヶ月間あたり8%).
- CD4 カウンター ≤20 細胞/μL の患者では,すべての死亡の発生率は,早期のHAART 時代と比較して,HAART 時代の後期に著しく低下しました.
- エイズ発生率は,CD4カウントに関係なく,早期のHAART時代と比較して,遅いHAART時代に約50%低かった.
結論:
- HAART導入後の死亡率と発症率の初期減少は持続しています.
- HAARTの潜在的な長期的な副作用は,AIDSの治療におけるその有効性を低下させていません.
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