PMID- 18240856
OWN - NLM
STAT- MEDLINE
DCOM- 20080312
LR  - 20080324
IS  - 1359-6535 (Print)
IS  - 1359-6535 (Linking)
VI  - 12
IP  - 8
DP  - 2007
TI  - Adverse events to antiretrovirals in the Swiss HIV Cohort Study: effect on 
      mortality and treatment modification.
PG  - 1157-64
AB  - BACKGROUND: Antiretroviral therapy (ART) decreases morbidity and mortality in 
      HIV-infected patients but is associated with considerable adverse events (AEs). 
      METHODS: We examined the effect of AEs to ART on mortality, treatment 
      modifications and drop-out in the Swiss HIV Cohort Study. A cross-sectional 
      evaluation of prevalence of 13 clinical and 11 laboratory parameters was 
      performed in 1999 in 1,078 patients on ART. AEs were defined as abnormalities 
      probably or certainly related to ART. A score including the number and severity 
      of AEs was defined. The subsequent progression to death, drop-out and treatment 
      modification due to intolerance were evaluated according to the baseline AE score 
      and characteristics of individual AEs. RESULTS: Of the 1,078 patients, laboratory 
      AEs were reported in 23% and clinical AEs in 45%. During a median follow up of 
      5.9 years, laboratory AEs were associated with higher mortality with an adjusted 
      hazard ratio (HR) of 1.3 (95% confidence interval [CI] 1.2-1.5; P < 0.001) per 
      score point. For clinical AEs no significant association with increased mortality 
      was found. In contrast, an increasing score for clinical AEs (HR 1.11,95% CI 
      1.04-1.18; P = 0.002), but not for laboratory AEs (HR 1.07, 95% CI 0.97-1.17; P = 
      0.17), was associated with antiretroviral treatment modification. AEs were not 
      associated with a higher drop-out rate. CONCLUSIONS: The burden of laboratory AEs 
      to antiretroviral drugs is associated with a higher mortality. Physicians seem to 
      change treatments to relieve clinical symptoms, while accepting laboratory AEs. 
      Minimizing laboratory drug toxicity seems warranted and its influence on survival 
      should be further evaluated.
FAU - Keiser, Olivia
AU  - Keiser O
AD  - Institute of Social and Preventive Medicine (ISPM), University of Bern, 
      Switzerland.
FAU - Fellay, Jacques
AU  - Fellay J
FAU - Opravil, Milos
AU  - Opravil M
FAU - Hirsch, Hans H
AU  - Hirsch HH
FAU - Hirschel, Bernard
AU  - Hirschel B
FAU - Bernasconi, Enos
AU  - Bernasconi E
FAU - Vernazza, Pietro L
AU  - Vernazza PL
FAU - Rickenbach, Martin
AU  - Rickenbach M
FAU - Telenti, Amalio
AU  - Telenti A
FAU - Furrer, Hansjakob
AU  - Furrer H
CN  - Swiss HIV Cohort Study
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Antivir Ther
JT  - Antiviral therapy
JID - 9815705
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
MH  - Adult
MH  - Anti-Retroviral Agents/*adverse effects/therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - *HIV
MH  - HIV Infections/*drug therapy/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Survival Analysis
MH  - Switzerland
MH  - Treatment Outcome
MH  - Withholding Treatment
EDAT- 2008/02/05 09:00
MHDA- 2008/03/13 09:00
CRDT- 2008/02/05 09:00
PHST- 2008/02/05 09:00 [pubmed]
PHST- 2008/03/13 09:00 [medline]
PHST- 2008/02/05 09:00 [entrez]
PST - ppublish
SO  - Antivir Ther. 2007;12(8):1157-64.