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Title

Survival in 2367 zidovudine-treated patients according to use of other nucleoside analogue drugs. The EuroSIDA Study Group

Authors
Phillips, A. N.
Katlama, C.
Barton, S.
Vella, S.
Blaxhult, A.
Clotet, B.
Goebel, F. D.
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Published in Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1998, vol. 17, no. 3, p. 239-244
Abstract To evaluate survival according to use of different nucleoside drugs in a routine clinical setting, we studied a large group of zidovudine-treated patients seen in clinics across Europe. A total of 3128 subjects was recruited to the observational, prospective EuroSIDA study in May 1994. These were consecutive patients (up to a predefined limit) seen at outpatient clinics in 37 centers from 16 European countries and followed at 6-month intervals by use of standardized forms completed by clinicians at the respective centers. This report concerns 2367 subjects who began antiretroviral therapy with a regime that included zidovudine either before study entry or during the course of follow-up. Cox proportional hazards models were fitted, with use of other antiretroviral drugs, CD4 count, and date of development of AIDS fitted as time-dependent covariates. Survival times from start of therapy were left truncated at study entry to avoid survival bias. In addition to zidovudine, antiretroviral drugs used included didanosine (ddI) (n = 1119; median 1.6 years after starting zidovudine), dideoxycytidine (ddC) (n = 592; median 1.9 years after starting zidovudine), stavudine (d4T) (n = 241; median 2.9 years after starting zidovudine) and lamivudine (3TC) (n = 33 ; median 2.7 years after starting zidovudine). Of the 2367 patients, 613 died during follow-up. Overall, risk of death was reduced in those zidovudine-treated patients who began at least one other nucleoside analogue drug with or after taking zidovudine (relative hazard [RH], 0.61; 95% confidence interval [CI], 0.51-0.72, adjusting for CD4 count, development of AIDS, and age). Fitting each drug separately, there was a larger association with reduced mortality for starting 3TC (RH, 0.41; 95% CI, 0.28-0.62) than for starting ddl (RH, 0.79; 95% CI, 0.67-0.93), ddC (RH, 0.74; 95% CI, 0.59-0.92) or d4T (RH, 0.67; 95% CI, 0.49-0.91). These results suggest that the beneficial effect of nucleoside combination therapy identified in controlled trials can be seen in routine clinical practice.
Keywords AdultAnti-HIV Agents/ therapeutic useCD4 Lymphocyte CountCohort StudiesDidanosine/therapeutic useDideoxynucleosides/ therapeutic useDisease ProgressionDrug Therapy, CombinationEuropeFemaleFollow-Up StudiesHIV Infections/ drug therapy/mortalityHumansLamivudine/therapeutic useMaleMiddle AgedProportional Hazards ModelsProspective StudiesStavudine/therapeutic useSurvival AnalysisZalcitabine/therapeutic useZidovudine/ therapeutic use
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PMID: 9495224
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PHILLIPS, A. N. et al. Survival in 2367 zidovudine-treated patients according to use of other nucleoside analogue drugs. The EuroSIDA Study Group. In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 1998, vol. 17, n° 3, p. 239-244. https://archive-ouverte.unige.ch/unige:9415

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Deposited on : 2010-07-12

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