Ophthalmology · 2009
Mortality associated with resistant cytomegalovirus among patients with cytomegalovirus retinitis and AIDS.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Jabs Douglas A, Martin Barbara K, Forman Michael S, Cytomegalovirus Retinitis and Viral Resistance Research Group
Аннотация
OBJECTIVE: To evaluate the effect of drug-resistant cytomegalovirus (CMV) on survival among patients with CMV retinitis.
DESIGN: Prospective cohort study during 1993 to 2003.
PARTICIPANTS: We included 266 patients with AIDS and newly diagnosed CMV retinitis treated with either ganciclovir or foscarnet.
METHODS: Data on ganciclovir and foscarnet resistance were obtained from blood and urine specimens collected at regular, predetermined intervals. The effect of resistant CMV on mortality was evaluated with a time-dependent Cox proportional hazard model.
MAIN OUTCOME MEASURES: Mortality.
RESULTS: The median survival of the entire cohort was 12.6 months. Analysis of risk factors for mortality demonstrated that resistant CMV was associated with an increased mortality (hazard ratio, 1.65; 95% confidence interval, 1.05-2.56; P = 0.032). Among the other parameters tested, only time since AIDS diagnosis was associated significantly with mortality, with a hazard ratio of 1.10 per year since AIDS diagnosis (P = 0.001).
CONCLUSIONS: Resistant CMV is associated with increased mortality among patients with AIDS being treated for CMV retinitis.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
DESIGN: Prospective cohort study during 1993 to 2003.
PARTICIPANTS: We included 266 patients with AIDS and newly diagnosed CMV retinitis treated with either ganciclovir or foscarnet.
METHODS: Data on ganciclovir and foscarnet resistance were obtained from blood and urine specimens collected at regular, predetermined intervals. The effect of resistant CMV on mortality was evaluated with a time-dependent Cox proportional hazard model.
MAIN OUTCOME MEASURES: Mortality.
RESULTS: The median survival of the entire cohort was 12.6 months. Analysis of risk factors for mortality demonstrated that resistant CMV was associated with an increased mortality (hazard ratio, 1.65; 95% confidence interval, 1.05-2.56; P = 0.032). Among the other parameters tested, only time since AIDS diagnosis was associated significantly with mortality, with a hazard ratio of 1.10 per year since AIDS diagnosis (P = 0.001).
CONCLUSIONS: Resistant CMV is associated with increased mortality among patients with AIDS being treated for CMV retinitis.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.