Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions

Objective: The link between CNS penetration of antiretrovirals and AIDS-defining neurologic disorders remains largely unknown. Methods: HIV-infected, antiretroviral therapy-naive individuals in the HIV-CAUSAL Collaboration who started an antiretroviral regimen were classified according to the CNS Pe...

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Autores: Caniglia, Ellen C., Cain, Lauren E., Justice, Amy C., Tate, Janet, Logan, Roger, Sabin, Caroline, Winston, Alan, Sighem, Ard van, Miró Meda, José M. (José María), 1956-, Podzamczer Palter, Daniel, Olson, Ashley D., Arribas, José Ramón, Moreno Guillén, Santiago, Meyer, Laurence, Romero, Jorge del, Dabis, François, Bucher, Heiner C., Wandeler, Gilles, Vourli, Georgia, Skoutelis, Athanasios, Lanoy, Emilie, Gasnault, Jacques, Costagliola, Dominique, Hernán, Miguel A., HIV-CAUSAL Collaboration
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/125906
Acceso en línea:https://hdl.handle.net/2445/125906
Access Level:acceso abierto
Palabra clave:Sida
Antiretrovirals
Manifestacions neurològiques de les malalties
AIDS (Disease)
Antiretroviral agents
Neurologic manifestations of general diseases
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spelling Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditionsCaniglia, Ellen C.Cain, Lauren E.Justice, Amy C.Tate, JanetLogan, RogerSabin, CarolineWinston, AlanSighem, Ard vanMiró Meda, José M. (José María), 1956-Podzamczer Palter, DanielOlson, Ashley D.Arribas, José RamónMoreno Guillén, SantiagoMeyer, LaurenceRomero, Jorge delDabis, FrançoisBucher, Heiner C.Wandeler, GillesVourli, GeorgiaSkoutelis, AthanasiosLanoy, EmilieGasnault, JacquesCostagliola, DominiqueHernán, Miguel A.HIV-CAUSAL CollaborationSidaAntiretroviralsManifestacions neurològiques de les malaltiesAIDS (Disease)Antiretroviral agentsNeurologic manifestations of general diseasesObjective: The link between CNS penetration of antiretrovirals and AIDS-defining neurologic disorders remains largely unknown. Methods: HIV-infected, antiretroviral therapy-naive individuals in the HIV-CAUSAL Collaboration who started an antiretroviral regimen were classified according to the CNS Penetration Effectiveness (CPE) score of their initial regimen into low (,8), medium (8-9), or high (.9) CPE score. We estimated "intention-to-treat" hazard ratios of 4 neuroAIDS conditions for baseline regimens with high and medium CPE scores compared with regimens with a low score. We used inverse probability weighting to adjust for potential bias due to infrequent follow-up. Results: A total of 61,938 individuals were followed for a median (interquartile range) of 37 (18, 70) months. During follow-up, there were 235 cases of HIV dementia, 169 cases of toxoplasmosis, 128 cases of cryptococcal meningitis, and 141 cases of progressive multifocal leukoencephalopathy. The hazard ratio (95% confidence interval) for initiating a combined antiretroviral therapy regimen with a high vs low CPE score was 1.74 (1.15, 2.65) for HIV dementia, 0.90 (0.50, 1.62) for toxoplasmosis, 1.13 (0.61, 2.11) for cryptococcal meningitis, and 1.32 (0.71, 2.47) for progressive multifocal leukoencephalopathy. The respective hazard ratios (95% confidence intervals) for a medium vs low CPE score were 1.01 (0.73, 1.39), 0.80 (0.56, 1.15), 1.08 (0.73, 1.62), and 1.08 (0.73, 1.58). Conclusions: We estimated that initiation of a combined antiretroviral therapy regimen with a high CPE score increases the risk of HIV dementia, but not of other neuroAIDS conditions.Lippincott, Williams & Wilkins. Wolters Kluwer Health2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/125906Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1212/WNL.0000000000000564Neurology, 2014, vol. 83, num. 2, p. 134-141https://doi.org/10.1212/WNL.0000000000000564(c) American Academy of Neurology, 2014info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1259062026-05-27T06:46:51Z
dc.title.none.fl_str_mv Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
title Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
spellingShingle Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
Caniglia, Ellen C.
Sida
Antiretrovirals
Manifestacions neurològiques de les malalties
AIDS (Disease)
Antiretroviral agents
Neurologic manifestations of general diseases
title_short Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
title_full Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
title_fullStr Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
title_full_unstemmed Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
title_sort Antiretroviral penetration into the CNS and incidence of AIDS-defining neurologic conditions
dc.creator.none.fl_str_mv Caniglia, Ellen C.
Cain, Lauren E.
Justice, Amy C.
Tate, Janet
Logan, Roger
Sabin, Caroline
Winston, Alan
Sighem, Ard van
Miró Meda, José M. (José María), 1956-
Podzamczer Palter, Daniel
Olson, Ashley D.
Arribas, José Ramón
Moreno Guillén, Santiago
Meyer, Laurence
Romero, Jorge del
Dabis, François
Bucher, Heiner C.
Wandeler, Gilles
Vourli, Georgia
Skoutelis, Athanasios
Lanoy, Emilie
Gasnault, Jacques
Costagliola, Dominique
Hernán, Miguel A.
HIV-CAUSAL Collaboration
author Caniglia, Ellen C.
author_facet Caniglia, Ellen C.
Cain, Lauren E.
Justice, Amy C.
Tate, Janet
Logan, Roger
Sabin, Caroline
Winston, Alan
Sighem, Ard van
Miró Meda, José M. (José María), 1956-
Podzamczer Palter, Daniel
Olson, Ashley D.
Arribas, José Ramón
Moreno Guillén, Santiago
Meyer, Laurence
Romero, Jorge del
Dabis, François
Bucher, Heiner C.
Wandeler, Gilles
Vourli, Georgia
Skoutelis, Athanasios
Lanoy, Emilie
Gasnault, Jacques
Costagliola, Dominique
Hernán, Miguel A.
HIV-CAUSAL Collaboration
author_role author
author2 Cain, Lauren E.
Justice, Amy C.
Tate, Janet
Logan, Roger
Sabin, Caroline
Winston, Alan
Sighem, Ard van
Miró Meda, José M. (José María), 1956-
Podzamczer Palter, Daniel
Olson, Ashley D.
Arribas, José Ramón
Moreno Guillén, Santiago
Meyer, Laurence
Romero, Jorge del
Dabis, François
Bucher, Heiner C.
Wandeler, Gilles
Vourli, Georgia
Skoutelis, Athanasios
Lanoy, Emilie
Gasnault, Jacques
Costagliola, Dominique
Hernán, Miguel A.
HIV-CAUSAL Collaboration
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Sida
Antiretrovirals
Manifestacions neurològiques de les malalties
AIDS (Disease)
Antiretroviral agents
Neurologic manifestations of general diseases
topic Sida
Antiretrovirals
Manifestacions neurològiques de les malalties
AIDS (Disease)
Antiretroviral agents
Neurologic manifestations of general diseases
description Objective: The link between CNS penetration of antiretrovirals and AIDS-defining neurologic disorders remains largely unknown. Methods: HIV-infected, antiretroviral therapy-naive individuals in the HIV-CAUSAL Collaboration who started an antiretroviral regimen were classified according to the CNS Penetration Effectiveness (CPE) score of their initial regimen into low (,8), medium (8-9), or high (.9) CPE score. We estimated "intention-to-treat" hazard ratios of 4 neuroAIDS conditions for baseline regimens with high and medium CPE scores compared with regimens with a low score. We used inverse probability weighting to adjust for potential bias due to infrequent follow-up. Results: A total of 61,938 individuals were followed for a median (interquartile range) of 37 (18, 70) months. During follow-up, there were 235 cases of HIV dementia, 169 cases of toxoplasmosis, 128 cases of cryptococcal meningitis, and 141 cases of progressive multifocal leukoencephalopathy. The hazard ratio (95% confidence interval) for initiating a combined antiretroviral therapy regimen with a high vs low CPE score was 1.74 (1.15, 2.65) for HIV dementia, 0.90 (0.50, 1.62) for toxoplasmosis, 1.13 (0.61, 2.11) for cryptococcal meningitis, and 1.32 (0.71, 2.47) for progressive multifocal leukoencephalopathy. The respective hazard ratios (95% confidence intervals) for a medium vs low CPE score were 1.01 (0.73, 1.39), 0.80 (0.56, 1.15), 1.08 (0.73, 1.62), and 1.08 (0.73, 1.58). Conclusions: We estimated that initiation of a combined antiretroviral therapy regimen with a high CPE score increases the risk of HIV dementia, but not of other neuroAIDS conditions.
publishDate 2014
dc.date.none.fl_str_mv 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/125906
url https://hdl.handle.net/2445/125906
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1212/WNL.0000000000000564
Neurology, 2014, vol. 83, num. 2, p. 134-141
https://doi.org/10.1212/WNL.0000000000000564
dc.rights.none.fl_str_mv (c) American Academy of Neurology, 2014
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American Academy of Neurology, 2014
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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