ABSTRACT
HAART has substantially decreased mortality and morbidity among HIV-infected patients. We retrospectively analyzed morbidity and mortality in a cohort of HIV-infected adult patients with prolonged and frequent follow up (1987-2006). The study was divided in pre-HAART and HAART period for comparative reasons. In total, 615 HIV-infected patients (54 females) were included in our study. 144 died during the pre-HAART period (51.4 deaths per 100 patients). During the HAART period only 38 patients died from a total of 335 patients receiving HAART (11.3 deaths per 100 patients); the follow up in this part of the cohort was 2139 persons-years and the death incidence 1.77 deaths/per 100 person-years. The subanalysis excluding patients who died within 3 months from admission showed that death incidence among patients that have been receiving HAART from the time of diagnosis (1.2 deaths per 100 person-years) was slightly lower, compared to the death incidence of patients treated for some time with non-HAART as well (1.58 deaths per 100 persons-years). After the availability of HAART in this unit, the proportion of non-AIDS related deaths increased significantly from 8% to 40% (p<0.001); infections remained the leading cause of death in both groups of patients. Tauhe most common non-AIDS related causes of deaths were cancer and coronary disease. Our data from the studied cohort adds to the relevant literature regarding the dramatic reduction of morbidity and mortality that occurred after the availability of HAART.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , HIV Infections/mortality , HIV/growth & development , Adult , Cohort Studies , Female , Greece/epidemiology , HIV Infections/virology , Humans , Incidence , Male , Morbidity , Retrospective Studies , Treatment OutcomeABSTRACT
The objective was to study the prevalence of genotypic resistance to nucleoside analogues (NRTIs), nonnucleoside analogues (NNRTIs), and protease inhibitors among HIV-1-infected persons in Athens, Greece. Patients followed at two HIV units were examined for prevalence of emergence of antiretroviral resistance mutations (ARMs) in this observational study where complete therapy history was available. All mutations were recorded according to the October/November 2005 IAS-USA Drug Resistance Mutations Figures. A total of 234 patients underwent genotypic testing of 2069 followed (1987-2004). The most frequent ARMs of each drug category were to NRTIs at codons M184V [present in 149 tests (63.6%)], M41L [79 (33.8%)], K70R [66 (28.2%)], M184VI [58 (24.8%)], T215YF [53 (22.7%)], D67N [82 (35.0%)], T215Y [72 (30.8%)], K219Q [47 (20.1%)], K219E/Q [54 (23.1%)], and L210W [49 (20.9%)], respectively. The most prevalent mutations related to NNRTIs were K103N [present in 59 tests (25.2%)], G190A [50 (21.4%)], and Y181C [48 (20.5%]. Mutations in the protease gene showed that the ARM at residue L63P was the most prevalent present in 119 samples (50.9%). L90M (26.5%) was among the most frequently observed single key protease mutations in our series, although variables of V82 and I54 amino acid substitutions were more frequent. M184V (63.6%) and K103N (25.2%) were the most frequent mutations related to NRTIs and NNRTIs, respectively.
Subject(s)
Anti-HIV Agents/pharmacology , Drug Resistance, Viral/genetics , HIV Infections/epidemiology , HIV-1/drug effects , Reverse Transcriptase Inhibitors/pharmacology , Adult , Aged , Aged, 80 and over , Anti-HIV Agents/therapeutic use , Drug Therapy, Combination , Genotype , Greece/epidemiology , HIV Infections/drug therapy , HIV Infections/virology , HIV Protease/genetics , HIV Reverse Transcriptase/genetics , HIV-1/enzymology , HIV-1/genetics , Humans , Middle Aged , Mutation , Prevalence , Reverse Transcriptase Inhibitors/therapeutic useABSTRACT
We conducted a case-control study in a Greek hospital to evaluate the prevalence and morbidity of Helicobacter pylori in HIV-infected patients. HIV-seropositive patients were infected by H. pylori less often than HIV-seronegative controls [12/58 (20.7%) versus 38/58 (65.5%),p < 0.001]. The mean CD4 count was lower for H. pylori-negative than H. pylori-positive HIV-infected patients (p < 0.007). Also, among HIV patients, prior use of antibiotics or proton pump inhibitors was more common in those without H. pylori infection, however, this difference was not statistically significant (p = 0.06). The grading of the density of H. pylori infection and the grading of the histomorphological findings according to the Sydney classification were similar between HIV-seropositive and -seronegative patients with H. pylori infection.
