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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Acquired Immunodeficiency Syndrome, Adult, CD4 Lymphocyte Count, Case-Control Studies, Drug Resistance, Viral, Female, Humans, Logistic Models, Longitudinal Studies, Male, Randomized Controlled Trials as Topic, Retrospective Studies, Viral Load.
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Are lower CD4 cell count and higher virus load , but not antiretroviral drug resistance , associated with AIDS-defining events and mortality : an ACTG Longitudinal Linked Randomized Trials ( ALLRT ) analysis? Context: We hypothesized that drug resistance mutations would impact clinical outcomes associated with HIV-1 infection. A matched case-control study of participants in AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT). Cases experienced an AIDS-defining event (ADE) or mortality, and controls did not. One hundred thirty-four cases were identified and matched to a total of 266 controls by age, sex, treatment regimen, and length of follow-up. Both cases and controls had HIV RNA levels of ≥ 500 copies/mL within 24 weeks of an event. Population-based genotyping at or near the time of the event was used to evaluate the impact of resistance mutations on incidence of ADE and/or death using conditional logistic regression models. One hundred four cases and 183 controls were analyzed. Median time to event was 99 weeks; 6 cases were deaths. At baseline, cases had lower CD4 (median 117 vs 235 cells/mm3; P < .0001) and higher HIV RNA levels (median 205,000 vs 57,000 copies/mL; P = .003). No significant differences in resistance were seen between cases and controls.
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In this rigorously designed case-control study, lower CD4 cell counts and higher virus loads, not antiretroviral drug resistance, were strongly associated with ADE and mortality. Final Decision: yes