Higher Baseline Levels of Plasma Human Immunodeficiency Virus Type 1 RNA Are Associated with Increased Mortality after Initiation of Triple‐Drug Antiretroviral Therapy

Abstract

We evaluated 1422 antiretroviral therapy (ART)–naive patients infected with human immunodeficiency virus (HIV) who initiated highly active antiretroviral therapy between 1 August 1 1996 and 31 July 2000 and were monitored until 31 March 2002. Patients were stratified on the basis of baseline levels of HIV RNA (<50,000, 50,000–99,999, and ⩾100,000 copies/mL). Cox regression was used to determine independent predictors of time to death. After adjustment for adherence to ART and other potential confounders, baseline levels of HIV RNA of ⩾100,000 copies/mL remained independently associated with mortality (adjusted relative hazard, 1.71; 95% confidence interval, 1.08–2.70; P=.023). If appropriately confirmed, these findings have important implications for the development of therapeutic guidelines