Universität zu Köln

Oette, Mark, Reuter, Stefan, Kaiser, Rolf, Jensen, Bjoern, Lengauer, Thomas, Faetkenheuer, Gerd, Knechten, Heribert, Hower, Martin, Sagir, Abdurrahman, Pfister, Herbert and Haeussinger, Dieter (2013). Ambulatory care for HIV-infected patients: differences in outcomes between hospital-based units and private practices: analysis of the RESINA cohort. Eur. J. Med. Res., 18. LONDON: BMC. ISSN 2047-783X

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Abstract

Background: The efficacy of highly active antiretroviral therapy (HAART) in the treatment of HIV infection is influenced by factors such as potency of applied drugs, adherence of the patient, and resistance-associated mutations. Up to now, there is insufficient data on the impact of the therapeutic setting. Methods: Since 2001, the prospective multicenter RESINA study has examined the epidemiology of transmitted HIV drug resistance in Nordrhein-Westfalen, the largest federal state of Germany by population. Characteristics of patients treated in hospital-based outpatient units were compared to those of patients treated in medical practices. Longitudinal data of all participants are being followed in a cohort study. Results: Overall, 1,591 patients were enrolled between 2001 and 2009 with follow-up until the end of 2010. Of these, 1,099 cases were treated in hospital-based units and 492 in private practices. Significant differences were found with respect to baseline characteristics. A higher rate of patients with advanced disease and non-European nationality were cared for in hospital units. Patients in medical practices were predominantly Caucasian men who have sex with men (MSM) harboring HIV-1 subtype B, with lower CDC stage and higher CD4 cell count. Median viral load was 68,828 c/mL in hospital-based units and 100,000 c/mL in private practices (P = 0.041). Only median age and rate of transmitted drug resistance were not significantly different. After 48 weeks, 81.9% of patients in hospital units and 85.9% in private practices had a viral load below the limit of detection (P = 0.12). A similar result was seen after 96 weeks (P = 0.54). Although the baseline CD4 cell count was different (189.5/mu L in hospital units and 246.5/mu L in private practices, P < 0.001), a consistent and almost identical increase was determined in both groups. Conclusions: The RESINA study covers a large HIV-infected patient cohort cared for in specialized facilities in Germany. Despite significant differences of patients' baseline characteristics in hospital-based units compared to medical practices, we could not find significant differences in treatment outcome up to 2 years after the initiation of HAART.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Oette, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaiser, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Jensen, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED Lengauer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Knechten, Heribert UNSPECIFIED UNSPECIFIED UNSPECIFIED Hower, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Sagir, Abdurrahman UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Herbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Haeussinger, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471868
DOI:	10.1186/2047-783X-18-48
Journal or Publication Title:	Eur. J. Med. Res.
Volume:	18
Date:	2013
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2047-783X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 1ST-LINE ANTIRETROVIRAL THERAPY; DRUG-RESISTANCE Multiple languages Medicine, Research & Experimental Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47186