Evidence for risk stratification when monitoring for toxicities following initiation of combination antiretroviral therapy

Babafemi Taiwo, Elizabeth L. Yanik, Sonia Napravnik, Patrick Ryscavage, Susan L. Koletar, Richard D Moore, W. Christopher Mathews, Heidi M. Crane, Kenneth Mayer, Anne Zinski, James S. Kahn, Joseph J. Eron

Research output: Contribution to journalArticle

Abstract

Objective: Laboratory monitoring is recommended during combination antiretroviral therapy (cART), but the pattern of detected abnormalities and optimal monitoring are unknown. We assessed laboratory abnormalities during initial cART in 2000-2010 across the United States. Design: Observational study in the Centers for AIDS Research Network of Integrated Clinical Systems Cohort. Methods: Among patients with normal results within a year prior to cART initiation, time to first significant abnormality was assessed by Kaplan-Meier curves stratified by event type, with censoring at first of regimen change, loss to follow-up, or 104 weeks. Incidence rates of first events were estimated using Poisson regression; multivariable analyses identified associated factors. Results were stratified by time (16 weeks) from therapy initiation. Results: A total of 3470 individuals contributed 3639 person-years. Median age, pre-cART CD4, and follow-up duration were 40 years, 206 cells/μl, and 51 weeks, respectively. Incidence rates for significant abnormalities (per 100 person-years) in the first 16 weeks post-cART initiation were as follows: lipid = 49 [95% confidence interval (CI) 41 - 58]; hematologic = 44 (40-49); hepatic = 24 (20-27); and renal = 9 (7-11), dropping substantially during weeks 17-104 of cART to lipid = 23 (18-29); hematologic = 5 (4-6); hepatic = 6 (5-8); and renal = 2 (1-3) (all P

Original languageEnglish (US)
Pages (from-to)1593-1602
Number of pages10
JournalAIDS
Volume27
Issue number10
DOIs
StatePublished - Jun 19 2013

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Therapeutics
Kidney
Lipids
Liver
Incidence
Observational Studies
Acquired Immunodeficiency Syndrome
Confidence Intervals
Research

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases
  • Medicine(all)

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Evidence for risk stratification when monitoring for toxicities following initiation of combination antiretroviral therapy. / Taiwo, Babafemi; Yanik, Elizabeth L.; Napravnik, Sonia; Ryscavage, Patrick; Koletar, Susan L.; Moore, Richard D; Mathews, W. Christopher; Crane, Heidi M.; Mayer, Kenneth; Zinski, Anne; Kahn, James S.; Eron, Joseph J.

In: AIDS, Vol. 27, No. 10, 19.06.2013, p. 1593-1602.

Research output: Contribution to journalArticle

Taiwo, B, Yanik, EL, Napravnik, S, Ryscavage, P, Koletar, SL, Moore, RD, Mathews, WC, Crane, HM, Mayer, K, Zinski, A, Kahn, JS & Eron, JJ 2013, 'Evidence for risk stratification when monitoring for toxicities following initiation of combination antiretroviral therapy', AIDS, vol. 27, no. 10, pp. 1593-1602. https://doi.org/10.1097/QAD.0b013e3283601115
Taiwo, Babafemi ; Yanik, Elizabeth L. ; Napravnik, Sonia ; Ryscavage, Patrick ; Koletar, Susan L. ; Moore, Richard D ; Mathews, W. Christopher ; Crane, Heidi M. ; Mayer, Kenneth ; Zinski, Anne ; Kahn, James S. ; Eron, Joseph J. / Evidence for risk stratification when monitoring for toxicities following initiation of combination antiretroviral therapy. In: AIDS. 2013 ; Vol. 27, No. 10. pp. 1593-1602.
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AU - Taiwo, Babafemi

AU - Yanik, Elizabeth L.

AU - Napravnik, Sonia

AU - Ryscavage, Patrick

AU - Koletar, Susan L.

AU - Moore, Richard D

AU - Mathews, W. Christopher

AU - Crane, Heidi M.

AU - Mayer, Kenneth

AU - Zinski, Anne

AU - Kahn, James S.

AU - Eron, Joseph J.

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AB - Objective: Laboratory monitoring is recommended during combination antiretroviral therapy (cART), but the pattern of detected abnormalities and optimal monitoring are unknown. We assessed laboratory abnormalities during initial cART in 2000-2010 across the United States. Design: Observational study in the Centers for AIDS Research Network of Integrated Clinical Systems Cohort. Methods: Among patients with normal results within a year prior to cART initiation, time to first significant abnormality was assessed by Kaplan-Meier curves stratified by event type, with censoring at first of regimen change, loss to follow-up, or 104 weeks. Incidence rates of first events were estimated using Poisson regression; multivariable analyses identified associated factors. Results were stratified by time (16 weeks) from therapy initiation. Results: A total of 3470 individuals contributed 3639 person-years. Median age, pre-cART CD4, and follow-up duration were 40 years, 206 cells/μl, and 51 weeks, respectively. Incidence rates for significant abnormalities (per 100 person-years) in the first 16 weeks post-cART initiation were as follows: lipid = 49 [95% confidence interval (CI) 41 - 58]; hematologic = 44 (40-49); hepatic = 24 (20-27); and renal = 9 (7-11), dropping substantially during weeks 17-104 of cART to lipid = 23 (18-29); hematologic = 5 (4-6); hepatic = 6 (5-8); and renal = 2 (1-3) (all P

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