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Mortality Analysis of HIV-1 Infected Patients for Prioritizing Antiretroviral Drug Therapy

951

Panita Pathipvanich MD*,
Archawin Rojanawiwat MD**, Koya Ariyoshi MD***,****,
Toshiyuki Miura MD***,*****, Wadchara Pumpradit MD***,
Suchint Wongchoosie MD*, Pipat Yingseree MD******,
Paijit Warachit MD**, Pathom Sawanpanyalert MD**

* Lampang Hospital
** National Institute of Health, DMSc, MOPH
*** JICA-NIH Project, DMSc, MOPH
**** AIDS Research Center, National Institute of Infectious Diseases, Japan
***** Institute of Medical Science, University of Tokyo, Japan
****** Lampang Provincial Health Office

Abstract


Mortality data of patients, classified according to their clinical status and CD4+ cell count status, would be very useful to guide clinicians to prioritizing patients who need antiretroviral drug therapy. In the current study, the authors re-analyzed data derived from a previously published retrospective study of HIV-1-infected individuals at Lampang Hospital in northern Thailand (1) . According to the Cox proportional hazard model, compared to asymptomatic patients with a high CD4+ cell count (> 200 cell/ml), the mortality rate of asymptomatic patients with a medium CD4+ cell count (100-199 cell/ml) did not significantly differ. However, the mortality rate of patients with a CD4+ cell count below 100 cell/ml was at least 16 times higher, regardless of the presence of clinical symptoms. Based on these results, the authors produced a Lampang Hospital guideline of antiretroviral drug use; priority of antiretroviral therapy should, therefore, be given to patients with CD4+ cell count < 100 cell/ml.

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