@article{5d8adb804c1a44849da870adfadbf2a4,
title = "CD4 Counts and mortality in virologically suppressed us veterans",
abstract = "We used the Veterans Health Administration (VA) HIV Clinical Case Registry (CCR) to evaluate the association between annual CD4 averages and all-cause mortality in HIV-infected veterans during their initial episode of suppressive highly active antiretroviral therapy (HAART). We observed 1083 deaths in 14 769 patients. Unadjusted mortality rates in the top and bottom CD4 quintiles differed significantly from the mid CD4 strata. Mortality in the top CD4 quintile (?720 cells/mm3) was 14.1/1000 patient-years, 95% confidence interval (CI): 10.1-18.2, compared with 20.4 (CI: 15.5-25.3) in the next lower CD4 stratum (530-719 cells/mm3). This difference was significant in Cox proportional hazards model, controlling for demographics, hepatitis co-infections, low-level viremia, HAART adherence, and refill rates of individual antiretrovirals (HR: 1.4, CI: 1.13-1.73). Our results support early HAART initiation as advocated by the current US treatment guidelines for HIV infection.",
keywords = "CD4 count, HAART, mortality, stavudine, veterans",
author = "Henning Drechsler and Song Zhang and Mark Holodniy and Roger Bedimo",
note = "Funding Information: HD was involved in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; and in the preparation of the manuscript. SZ was involved in the design and conduct of the study, in the supervision and interpretation of the statistical analysis, and the review of the manuscript. MH was involved in the acquisition of the data, in the revision of the manuscript for intellectual content, and in the final approval for the submitted manuscript. RB was involved in the design and conduct of the study, in the analysis and interpretation of the data, and in the preparation and review of the manuscript. This study was approved by the Institutional Review Board of the Dallas VA Medical Center and its results were partially presented at the XIX International AIDS conference in Washington, DC, on July 23, 2012. The views expressed in this manuscript are those of the authors and do not necessarily reflect those of the Department of Veterans Affairs or the United States government. RB received research grants from Merck & Co, Tibotec Therapeutics, Bristol Myers Squibb and Abbott Pharmaceuticals. He also served as scientific advisor or consultant for EMD Serono, Merck & Co, Gilead, Tibotec Therapeutics and AIDS Arms. Acknowledgements ",
year = "2014",
doi = "10.1177/2325957413512153",
language = "English (US)",
volume = "13",
pages = "120--126",
journal = "Journal of the International Association of Providers of AIDS Care",
issn = "2325-9574",
publisher = "SAGE Publications Inc.",
number = "2",
}