Navigation und Service

Zielgruppeneinstiege

Abstract zur Publikation: The risk of AIDS-defining events is decreasing over time in the German HIV-1 Seroconverter Cohort

Altmann M, an der Heiden M, Scheufele R, Hartmann K, Houareau C, Bartmeyer B, Hamouda O (2012): The risk of AIDS-defining events is decreasing over time in the German HIV-1 Seroconverter Cohort.
BMC Infect. Dis. 12: 94. doi:10.1186/1471-2334-12-94.

Background

With ageing of the HIV-infected population, long-term exposure to treatment, varying adherence, emerging resistance and complications to therapies, effectiveness of Highly Active Antiretroviral Therapy (HAART) needs to be monitored continuously at the population level. The German HIV-1 Seroconverter Cohort is a multi-centre, open, long-term observational cohort including patients with a known or reliably estimated date of HIV infection – i.e. last negative and first positive HIV antibody test within a maximum three-year interval or laboratory evidence of seroconversion. Our study aims to investigate survival improvements and changes in AIDS risk over calendar periods in the German HIV-1 Seroconverter Cohort.

Methods

Retrospective (for the pre-1997 period) and prospective (since 1997) data from the German HIV-1 Seroconverter Cohort were used. Time from seroconversion to first AIDS-defining event over calendar periods was analysed by using Cox models adjusting for age at seroconversion, sex, transmission groups and short HIV test interval. Kaplan-Meier methods were used to determine expected survival (remaining AIDS-free) by calendar period.

Results

2162 seroconverters with 8976 person-years of observation were included in our analysis (up to 31.12.2010). A total of 196 first AIDS-defining events were reported. Two periods – i.e. 1997–2000 and 2007–2010 – were statistically associated with a reduction in the risk of AIDS, accounting for an overall reduction of 80%. Compared to1997–2000, hazard rations were 2.6 (95%CI, 1.6–4.8; p = 0.000) in pre-1997 and 0.5 (95%CI, 0.3–0.8; p = 0.007) in 2007–2010. Independent risk factor for AIDS progression was age at seroconversion (HR, 1.3 per 10 year-increase; p = 0.001).

Conclusion

HAART effectiveness has improved in the German HIV-1-Seroconverter Cohort. The risk to develop AIDS decreased significantly in 1997–2000 and in 2007–2010. However, elderly may require particular monitoring in view of their faster progression to AIDS.

Zusatzinformationen

Gesundheitsmonitoring

In­fek­ti­ons­schutz

Forschung

Kom­mis­sio­nen

Ser­vice

Das Robert Koch-Institut ist ein Bundesinstitut im Geschäftsbereich des Bundesministeriums für Gesundheit

© Robert Koch-Institut

Alle Rechte vorbehalten, soweit nicht ausdrücklich anders vermerkt.