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Int J Epidemiol. 2012 Dec;41(6):1807-20. doi: 10.1093/ije/dys164. Epub 2012 Nov 12.

Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America: relation with patient and cohort characteristics.

Collaborators (1134)

Gras LA, van Sighem AI, Smit C, de Wolf F, Prins JM, Bos JC, Eeftinck-Schattenkerk JK, Geerlings SE, Godfried MH, Lange JM, van der Meer JT, Nellen FJ, Olszyna DP, van der Poll T, Reiss P, Sankatsing SU, van der Valk M, Vermeulen JN, Vrouenraets SM, van Vugt M, Wit FW, Schreij G, van der Geest S, Oude Lashof A, Lowe S, Verbon A, Bravenboer B, Pronk MJ, Kuijpers TW, Pajkrt D, Scherpbier HJ, van der Ende ME, Bax H, van der Feltz M, Gelinck LB, de Melo M, Nouwen JL, Rijnders BJ, de Ruiter ED, Slobbe L, Schurink CA, de Vries TE, Driessen G, van der Flier M, Hartwig NG, Branger J, Kauffmann RH, Schippers EF, Groeneveld PH, Alleman MA, Kroon FP, Arend SM, de Boer MG, van den Broek PJ, van Dissel JT, van Nieuwkoop C, den Hollander JG, Bronsveld W, Pogány K, Haag D, Vriesendorp R, Jeurissen FJ, Leyten EM, van Houte D, Polée MB, van Vonderen M, ten Napel CH, Kootstra GJ, Brinkman K, van den Berk GE, Blok WL, Frissen PH, Schouten WE, van Eeden A, Verhagen DW, Mulder JW, van Gorp EC, Steingrover AT, Wagenaar J, Juttmann JR, van Kasteren ME, Veenstra J, Vasmel WL, Lettinga K, Koopmans PP, Brouwer AM, Dofferhoff AS, de Groot R, ter Hofstede HJ, Keuter M, van der Ven AJ, Sprenger HG, van Assen S, Stek CJ, Doedens R, Scholvinck EH, Hoepelman IM, Schneider MM, Bonten MJ, Ellerbroek PM, Jaspers CA, Maarschalk-Ellerbroek LJ, Oosterheert JJ, Peters EJ, Mudrikova T, Wassenberg MW, Weijer S, Hoogenwerf MH, Arends JE, Hoornenborg E, Geelen SP, Wolfs TF, Danner SA, van Agtmael MA, Bierman WF, Claessen FA, Hillebrand ME, de Jong EV, Kortmann W, Perenboom RM, de Vaate EA, Richter C, van der Berg J, Gisolf EH, Tanis AA, Duits AJ, Winkel K, Back NK, Bakker ME, Zaaijer HL, Berkhout B, Jurriaans S, Cuijpers T, Rietra PJ, Roozendaal KJ, Pauw W, Smits PH, van Zanten AP, von Blomberg BM, Pettersson A, Savelkoul P, Swanink CM, Franck PF, Lampe AS, Jansen CL, Hendriks R, Benne CA, Schirm J, Veenendaal D, Storm H, Weel J, van Zeijl JH, Claas HC, Kroes AC, Bruggeman CA, Goossens VJ, Galama JM, Melchers WJ, van Doornum GJ, Niesters HG, Osterhaus AD, Schutten M, Buiting AG, Boucher CA, Boel E, Schuurman R, Jansz AF, Wulf M, Veldkamp A, Beijnen JH, Huitema AD, Burger DM, van Kan HJ, Bruyand M, Chêne G, Dabis F, Lawson-Ayayi S, Thiébaut R, Bonarek M, Bonnal F, Bonnet F, Bernard N, Caubet O, Caunègre L, Cazanave C, Ceccaldi J, Dauchy FA, De La Taille C, De Witte S, Dupon M, Duffau P, Dutronc H, Farbos S, Greib C, Lacoste D, Lafarie S, Loste P, Malvy D, Mercié P, Morlat P, Neau D, Ochoa A, Pellegrin JL, Ragnaud JM, Tchamgoué S, Viallard JF, Blanco P, Moreau JF, Fleury H, Lafon ME, Masquelier B, Pellegrin I, Breilh D, Miremont-Salamé G, Blaizeau MJ, Decoin M, Delveaux S, Hannapier C, Labarrère S, Lavignolle-Aurillac V, Uwamaliya-Nziyumvira B, Geffard S, Palmer G, Touchard D, Dupon M, Longy-Boursier M, Morlat P, Pellegrin JL, Ragnaud JM, Dabis F, Fätkenheuer G, Rockstroh J, Hertenstein C, Vehreschild J, Wasmuth JC, Berenguer J, del Amo J, García F, Gutiérrez F, Labarga P, Moreno S, Muñoz MÁ, Sobrino P, Hernando V, Alejos B, Álvarez D, Monge S, Jarrín I, Muñoz MÁ, Martínez IG, Sirvent JL, Fortúnez PR, Valls MR, del Mar Alonso Socas M, Lirola AM, Hernández MI, Díaz-Flores F, Soriano V, Labarga P, Barreiro P, Castañares C, Rivas P, Ruiz A, Blanco F, García P, Rubio R, Pulido F, Fiorante S, Llenas J, Rodríguez V, Matarranz M, Iribarren JA, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy J, Gutiérrez F, Masiá M, Ramos JM, Padilla S, Navarro A, Montolio F, Peral Y, Berenguer J, Bernaldo JC, Miralles P, Ochaíta JC, Conde MS, Cuellar IG, Schacke MR, Ortega BP, Vidaurreta PG, Marañón G, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, López-Dupla M, Olona M, Aguilar A, Sirvent JJ, Soriano A, Rodríguez J, Aparicio AS, Sarriá C, Oteo JA, Blanco JR, Ibarra V, Metola L, Sanz M, Boneta JS, Uriz J, Castiello J, Reparaz J, Arraiza MJ, Irigoyen C, Mozas D, Moreno S, Casado JL, Dronda F, Moreno A, Elías MJ, López D, Gutiérrez C, Hernández B, Pumares M, García FG, Quero JH, Monje AP, Medina LM, del Amo J, Losso M, Kundro M, Mejia J, Vetter N, Zangerle R, Karpov I, Vassilenko A, Mitsura VM, Suetnov O, Clumeck N, Delforge M, Colebunders R, Vandekerckhove L, Hadziosmanovic V, Kostov K, Begovac J, Machala L, Jilich D, Sedlacek D, Nielsen J, Kronborg G, Benfield T, Larsen M, Gerstoft J, Katzenstein T, Hansen AB, Skinhøj P, Pedersen C, Ostergaard L, Zilmer K, Ristola M, Katlama C, Viard JP, Girard PM, Livrozet JM, Vanhems P, Pradier C, Dabis F, Neau D, Rockstroh J, Schmidt R, van Lunzen J, Degen O, Stellbrink HJ, Staszewski S, Goethe JW, Bogner J, Fätkenheuer G, Kosmidis J, Gargalianos P, Xylomenos G, Perdios J, Panos G, Filandras A, Karabatsaki E, Sambatakou H, Banhegyi D, Mulcahy F, Yust I, Turner D, Burke M, Pollack S, Hassoun G, Maayan S, Vella S, Esposito R, Mazeu I, Mussini C, Arici C, Pristera R, Mazzotta F, Gabbuti A, Vullo V, Lichtner M, Chirianni A, Montesarchio E, Gargiulo M, Antonucci G, Testa A, Offizi GD, Vlassi C, Zaccarelli M, Antorini A, Lazzarin A, Castagna A, Gianotti N, Galli M, Ridolfo A, Sacco L, d'Arminio Monforte A, Rozentale B, Zeltina I, Chaplinskas S, Staub T, Hemmer R, Reiss P, Ormaasen V, Maeland A, Bruun J, Knysz B, Gasiorowski J, Horban A, Bakowska E, Grzeszczuk A, Flisiak R, Boron-Kaczmarska A, Pynka M, Parczewski M, Beniowski M, Mularska E, Trocha H, Jablonowska E, Malolepsza E, Wojcik K, Antunes F, Doroana M, Caldeira L, Mansinho K, Maltez F, Duiculescu D, Babes V, Rakhmanova A, Zakharova N, Buzunova S, Jevtovic D, Mokráš M, Staneková D, Tomazic J, González-Lahoz J, Soriano V, Labarga P, Medrano J, Moreno S, Rodriguez J, Clotet B, Jou A, Paredes R, Tural C, Puig J, Bravo I, Gatell JM, Miró JM, Domingo P, Gutierrez M, Mateo G, Sambeat MA, Blaxhult A, Flamholc L, Ledergerber B, Weber R, Francioli P, Cavassini M, Hirschel B, Boffi E, Furrer H, Battegay M, Elzi L, Kravchenko E, Chentsova N, Frolov V, Kutsyna G, Servitskiy S, Krasnov M, Barton S, Johnson AM, Mercey D, Phillips A, Johnson MA, Mocroft A, Murphy M, Weber J, Scullard G, Fisher M, Leen C, Gatell J, Gazzard B, Horban A, Karpov I, Ledergerber B, Losso M, D'Arminio A, Pedersen C, Rakhmanova A, Ristola M, Rockstroh J, De Wit S, Lundgren J, Phillips A, Reiss P, Kirk O, Mocroft A, Cozzi-Lepri A, Grint D, Sabin M, Podlekareva D, Kjær J, Peters L, Nielsen J, Tverland J, Fischer AH, Kirk O, Mocroft A, Grarup J, Reiss P, Cozzi-Lepri A, Thiebaut R, Rockstroh J, Burger D, Paredes R, Kjær J, Peters L, Abgrall S, Barin F, Bentata M, Billaud E, Boué F, Burty C, Cabié A, Costagliola D, Cotte L, De Truchis P, Duval X, Duvivier C, Enel P, Fredouille-Heripret L, Gasnault J, Gaud C, Gilquin J, Grabar S, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary-Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorgé F, Poizot-Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot-Dupont H, Viard JP, Viget N, Jacquemet N, Abgrall S, Costagliola D, Grabar S, Guiguet M, Lanoy E, Lièvre L, Mary-Krause M, Selinger-Leneman H, Lacombe JM, Potard V, Pitié GH, Bricaire F, Herson S, Katlama C, Simon A, Desplanque N, Girard PM, Meynard JL, Meyohas MC, Picard O, Cadranel J, Mayaud C, Pialoux G, Clauvel JP, Decazes JM, Gerard L, Molina JM, Lariboisière-Fernand GH, Diemer M, Sellier P, Bentata M, Honoré P, Jeantils V, Tassi S, Mechali D, Taverne B, Bouvet E, Crickx B, Ecobichon JL, Matheron S, Picard-Dahan C, Yeni P, Berthé H, Dupont C, Chandemerle C, Mortier E, Tisne-Dessus D, Weiss L, Tarnier-Cochin GH, Salmon D, Auperin I, Gilquin J, Roudière L, Viard JP, Boué F, Fior R, Delfraissy JF, Goujard C, Jung C, Vittecoq D, Fraisse P, Lang JM, Rey D, Beck-Wirth G, Stahl JP, Lecercq P, Gourdon F, Laurichesse H, Fresard A, Lucht F, Bazin C, Verdon R, Chavanet P, Arvieux C, Michelet C, Choutet P, Goudeau A, Maître MF, Hoen B, Eglinger P, Faller JP, Borsa-Lebas F, Caron F, Reynes J, Daures JP, May T, Rabaud C, Berger JL, Rémy G, Arlet-Suau E, Cuzin L, Massip P, Legrand M, Pontonnier G, Viget N, Yasdanpanah Y, Dellamonica P, Pradier C, Pugliese P, Aleksandrowicz K, Quinsat D, Ravaux I, Tissot-Dupont H, Delmont JP, Moreau J, Gastaut JA, Poizot-Martin I, Retornaz F, Soubeyrand J, Galinier A, Ruiz JM, Allegre T, Blanc PA, Bonnet-Montchardon D, Lepeu G, Granet-Brunello P, Esterni JP, Pelissier L, Cohen-Valensi R, Nezri M, Chadapaud S, Laffeuillade A, Billaud E, Raffi F, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Cotte L, Trepo C, Strobel M, Saint-Martin CH, Bissuel F, Pradinaud R, Sobesky M, Cabié A, Gaud C, Contant M, Moroni M, Angarano G, Antinori A, Castelli F, Cauda R, d'Arminio Monforte A, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Armignacco O, Viale PL, Von Schlosser F, d'Arminio Monforte A, Ammassari A, Andreoni M, Antinori A, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Cinque P, Cozzi-Lepri A, d'Arminio Monforte A, De Luca A, Gargiulo M, Gervasoni C, Girardi E, Gori A, Guaraldi G, Lichtner M, Caputo SL, Madeddu G, Maggiolo F, Marchetti G, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Cozzi-Lepri A, Cicconi P, Fanti I, Formenti T, Galli L, Lorenzini P, Giacometti A, Costantini A, Riva A, Angarano G, Monno L, Carrisa C, Maggiolo F, Lazzari G, Viale PL, Borderi M, Verucchi G, Castelli F, Torti C, Minardi C, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Sighinolfi L, Segala D, Mazzotta F, Caputo S, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Bonfanti P, Caramma I, Chiodera A, Castelli P, Galli M, Lazzarin A, Rizzardini G, Puoti M, d'Arminio Monforte A, Ridolfo AL, Piolini R, Castagna A, Salpietro S, Galli A, Bigoloni A, Spagnuolo V, Carenzi L, Zucchi P, Moioli MC, Rossotti R, Cicconi P, Formenti T, Mussini C, Bisio L, Gori A, Lapadula G, Abrescia N, Chirianni A, Guida MG, Gargiulo M, Baldelli F, Belfiori B, Parruti G, Ursini T, Magnani G, Ursitti MA, Cauda R, Andreoni M, Antinori A, Tozzi V, Vullo V, De Luca A, d'Avino A, Zaccarelli M, Gallo L, Nicastro E, Acinapura R, Capozzi M, Libertone R, Lichtner M, Tebano G, Mura MS, Madeddu G, Caramello P, Di Perri G, Orofino GC, Sciandra M, Pellizzer G, Manfrin V, Casabona J, Miró JM, Casabona J, Esteve A, Alquézar A, Miró JM, Podzamczer D, Murillas J, Romero A, Agustí C, Gatell JM, Agüero F, Tural C, Clotet B, Ferrer E, Riera M, Navarro F, Force L, Vilaró J, Masabeu A, García I, Guadarrama M, Esteve A, Montoliu A, Ortega N, Lazzari E, Puchol E, Sanchez M, Blanco JL, Garcia-Alcaide F, Martinez E, López-Dieguez J, García-Goez JF, Sirera G, Romeu J, Jou A, Negredo E, Miranda C, Capitan MC, Olmo M, Barragan P, Saumoy M, Bolao F, Cabellos C, Peña C, Sala M, Cervantes M, Jose Amengual M, Navarro M, Penelo E, Barrufet P, Guadarrama M, Bhagani S, Carroll A, Cropley I, Cuthbertson Z, Drinkwater T, Dunleavy A, Fernandez T, Geretti AM, Marshall N, Murphy G, Nair D, Ivens D, Johnson M, Kinloch-de Loes S, Lipman M, Madge S, Mahungu T, Prinz B, Swaden L, Rodger A, Tyrer M, Youle M, Chaloner C, Holloway J, Puradiredja J, Scott S, Tsintas R, Cambiano V, Harris E, Lampe F, Lodwick R, Phillips A, Smith C, Amoah E, Booth C, Clewley G, Garcia Diaz A, Gregory B, Labbett W, Libaste J, Tahami F, Thomas M, Zhong Y, Aubert V, Barth J, Battegay M, Bernasconi E, Böni J, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Egger M, Elzi L, Fehr J, Fellay J, Francioli P, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hirschel B, Hösli I, Kahlert C, Kaiser L, Keiser O, Kind C, Klimkait T, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Metzner K, Müller N, Nadal D, Pantaleo G, Rauch A, Regenass S, Rickenbach M, Rudin C, Schmid P, Schultze D, Affolter F, Schüpbach J, Speck R, Taffé P, Tarr P, Telenti A, Trkola A, Vernazza P, Weber R, Yerly S, Gill J, Read R, Beckthold B, Akagi L, Brandson E, Druyts E, Fernandes K, Gataric N, Harrigan PR, Harris M, Hogg R, Lima V, Montaner J, Moore D, Palmer A, Wood E, Yip B, Zhang W, Guest JL, Rimland D, Moanna A, Hidron A, DeSilva KE, Moorfield M, Dorsey M, Mindley R, Wirtz SS, Brown P, Dozier R, Robinson Y, Saag MS, Mugavero MJ, Willig JH, Raper JL, Allison JJ, Kempf MC, Schumacher JE, Westfall AO, Lin HY, Pisu M, Moneyham L, Vance D, Bachmann L, Davies SL, Berner E, Acosta E, King J, Kaslow RA, Savage K, Nevin C, Walton FB, Marler ML, Lawrence S, Files-Kennedy B, Batey D, Patil MA, Patil U, Varshney M, Gibson E, Guzman A, Rinehart D, Brandt C, Crothers K, Dubrow R, Fiellin D, Freiberg M, Gandhi N, Goulet J, Justice A, Lim J, LoRe V, McGinnis K, Ohl M, Parikh C, Rimland D, Skanderson M, Tate J, Womack J, Brown S, Butt A, Gibert C, Goetz M, Oursler KA, Rodriguez-Barradas M, Simberkoff M, Sterling TR, Shepherd B, Hulgan T, McGowan C, Wester W, Melekhin V, Koethe J, Qian HZ, Kipp A, Raffanti S, Haas D, D'Aquila R, Stinnette S, Bebawy S, Turner M, Rasbach D, Tillman A, Heaton H, Jenkins C, Kitahata M, Crane H, Van Rompaey S, Harrington R, Lober B, Collier A, Simoni J, Tarczy-Hornoch P, Crothers K, Scott J, McCormick W, Mallolas M, Segura G, Thiercelin F, Ramos M, Mairuhu R.

Abstract

BACKGROUND:

HIV cohort collaborations, which pool data from diverse patient cohorts, have provided key insights into outcomes of antiretroviral therapy (ART). However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and mortality are unclear.

METHODS:

We obtained data on adult HIV-positive patients who started ART from 1998 without a previous AIDS diagnosis from 17 cohorts in North America and Europe. Patients were followed up from 1 month to 2 years after starting ART. We examined between-cohort heterogeneity in crude and adjusted (age, sex, HIV transmission risk, year, CD4 count and HIV-1 RNA at start of ART) rates of AIDS and mortality using random-effects meta-analysis and meta-regression.

RESULTS:

During 61 520 person-years, 754/38 706 (1.9%) patients died and 1890 (4.9%) progressed to AIDS. Between-cohort variance in mortality rates was reduced from 0.84 to 0.24 (0.73 to 0.28 for AIDS rates) after adjustment for patient characteristics. Adjusted mortality rates were inversely associated with cohorts' estimated completeness of death ascertainment [excellent: 96-100%, good: 90-95%, average: 75-89%; mortality rate ratio 0.66 (95% confidence interval 0.46-0.94) per category]. Mortality rate ratios comparing Europe with North America were 0.42 (0.31-0.57) before and 0.47 (0.30-0.73) after adjusting for completeness of ascertainment.

CONCLUSIONS:

Heterogeneity between settings in outcomes of HIV treatment has implications for collaborative analyses, policy and clinical care. Estimated mortality rates may require adjustment for completeness of ascertainment. Higher mortality rate in North American, compared with European, cohorts was not fully explained by completeness of ascertainment and may be because of the inclusion of more socially marginalized patients with higher mortality risk.

PMID:
23148105
PMCID:
PMC3535877
DOI:
10.1093/ije/dys164
[Indexed for MEDLINE]
Free PMC Article
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