Outcome of HAART for patients with CD4<50

David Haburchak

Research output: Contribution to journalArticle

Abstract

Objective: To examine the outcome and cost effectiveness of HAART in AIDS patients with CD4<50. Design: Prospective outcome comparison of benchmark cohorts. Participants: All AIDS patients seen at least one time in clinic with CD4<50 Jan 92-Apr 94 (Cohort 1, N=112) and period 1 Jan- 31 Dec 96 (Cohort 2, N=140). Intervention: Antiretroviral regimens were prescribed by 4 ID physicians based on individual patient clinical situation. Patients were defined as having "triple" therapy if prescribed 2RT+1PI for two months or more, "dual" if 2RT- no PI. Results: Pt months observed Cohort 1: 1961 mo., Cohort 2: 1522 mo. Effectiveness therapy (n) Cohort 1(1992-4) mono (112) Cohort 2 (1996) all(140) triple (71) dual (32)mono(16)no(21) CD4 rise over 50 2% 32% 52% 19% 12% 0% CD4 rise over 100 0% 16% 30% 3% 0 0% viral load < 500 NA 17% 27% 12% 6% 0% median survival from CD4<50 (months) 22 23.5 32.5 21.5 11.5 15.2 Prophylaxis failures % (94 vs 96): PCP (6,1.4); Crypto (4,2); Toxo (8,0);MAC (31,4) cohort 1 cohort 2 Resource Use (n) deaths (62) deaths(46) alive(81) triple dual mono no Admissions/month .17 .20 .06 .06 .10 .15 .24 Hosp days/month 1.57 1.53 .44 .44 .79 1.11 2.00 Clinic visits/month .70 .66 .56 .61 .50 .70 .57 Viral loads/month ND .15 .22 .24 .20 .15 .07 Estimated monthly cost $2720 2800 1666 1650 2079 3280 Conclusion: Selective HAART therapy in patients with CD4$50 is associated with prolonged survival, decreased resource utilization, and decreased monthly cost.

Original languageEnglish (US)
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Immunology

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