Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data from the PRESTIGIO Registry
- Authors: Galli L.; Parisi M.R.; Poli A.; Menozzi M.; Fiscon M.; Garlassi E.; Francisci D.; DI Biagio A.; Sterrantino G.; Fornabaio C.; Degli Antoni A.; Angarano G.; Fusco F.M.; D'Arminio Monforte A.; Corbelli G.M.; Santoro M.M.; Zazzi M.; Castagna A.; Castagna A.; Gianotti N.; Galli L.; Maggiolo F.; Calza L.; Foca E.; Sterrantino G.; Cenderello G.; Rusconi S.; Mussini C.; Menozzi M.; Antinori A.; Gagliardini R.; Bonora S.; Ferrara M.; Zazzi M.; Santoro M.; Corbelli G.M.; Zazzi M.; Santoro M.M.; Galli A.; Carini E.; Parisi M.R.; Galli L.; Poli A.; Bigoloni A.; Tavio M.; Butini L.; Giacometti A.; Vaccher E.; Martellotta F.; Da Ros V.; Angarano G.; Saracino A.; Balena F.; Maggiolo F.; Comi L.; DI Filippo E.; Valenti D.; Suardi C.; Mazzola B.; Viale P.; Calza L.; Del Turco E.R.; Ramirez M.V.; Castelli F.; Foca E.; Celotti A.; Brognoli F.; Bonoldi G.; Menzaghi B.; Abeli C.; Farinazzo M.; Ortu F.; Campus M.; Cacopardo B.; Celesia M.; Pan A.; Fornabaio C.; Bartoloni A.; Sterrantino G.; Rinaldi F.; Giache S.; Pierluigi B.; Vichi F.; Fusco F.M.; Santantonio T.; Ferrara S.; Bruno S.R.; Cassola G.; Cenderello G.; Marcello F.; Calautti F.; Bassetti M.; Bruzzone B.; Artioli S.; Lazzarin A.; Castagna A.; Gianotti N.; Carini E.; Parisi M.R.; Galli L.; Poli A.; Galli A.; Canetti D.; Galli M.; Rusconi S.; Formenti T.; Morena V.; Gabrieli A.; D'Arminio Monforte A.; Gazzola L.; Merlini E.; Minieri V.; Gori A.; Bandera A.; Pastore V.; Ferroni V.; Puoti M.; Moioli C.; Vassalli S.; Mussini C.; Menozzi M.; Enrica R.; Giulia N.; Beghetto B.; Manzillo E.; Franco A.; Cattelan A.M.; Marinello S.; Cavinato S.; MacArio A.; Cascio A.; Mazzola G.; Antoni A.M.D.; Ferrari C.; Laccabue D.; Filice G.; Gulminetti R.; Pagnucco L.; Asti A.; Frsdi E.; Schiaroli E.; Papalini C.; Italiani F.; DI Pietro M.; Magnani G.; Elisa G.; Barchi E.; Corsini R.; Antinori A.; Gagliardini R.; Vergori A.; Cicalini S.; Onnelli G.; Giannetti A.; Cauda R.; Ciccullo A.; La Monica S.; Vullo V.; Dettorre G.; Cavallari E.N.; Andreoni M.; Malagnino V.; Ceccarelli L.; Viviani F.; Sasset L.; Dentone C.; Rossetti B.; Modica S.; Borgo V.; DI Perri G.; Bonora S.; Ferrara M.; Carcieri C.; Malena M.; Fiscon M.; Padovani B.; Luzzati R.; Centonze S.; Valentinotti R.
- Publication year: 2020
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/510204
Abstract
Background: Currently, no data are available on the burden of morbidity and mortality in people with HIV-1 (PWH) harboring a 4-class drug-resistant (4DR) virus (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase strand transfer inhibitors). The study aimed to assess the incidence of clinical events and death in this population. Methods: This was a cohort study on PWH from the PRESTIGIO Registry with a documented 4DR virus. Burden of disease was defined as the occurrence of any new event including an AIDS-defining event (ADE) or non-AIDS-defining event (NADE) or death from any cause after 4DR evidence (baseline). Cox regression models evaluated factors associated with the risk of new clinical events/death. Results: Among 148 PWH followed for a median (interquartile range) of 47 (32-84) months after 4DR evidence, 38 PWH had 62 new events or died from any cause (incidence rate, 9.12/100 person-years of follow-up; 95% CI = 6.85-11.39): 12 deaths (6 AIDS-related and 6 non-AIDS-related), 18 ADEs, 32 NADEs; 20 of the 38 NADEs (45%) of the incident clinical events were malignancies. The 4-year cumulative incidence of death was 6% (95% CI, 3%-13%), and that of ≥1 event or death was 22% (95% CI, 16%-31%). A higher risk of new clinical events/death was more likely in PWH with previous clinical events (adjusted hazard ratio [aHR], 2.67; 95% CI, 1.07-6.67) and marginally associated with lower baseline CD4+/CD8+ ratio (aHR, 0.82; 95% CI, 0.65-1.02). Conclusions: PWH harboring 4DR have a high burden of disease with a worrying incidence of malignancies, strongly advising for close prevention and monitoring interventions as well as access to innovative therapeutic strategies, especially in people with a history of clinical events and low CD4+/CD8+ ratio.