Division of Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
To characterize the impact of intermittent use of triple drug antiretroviral therapy on survival.
Population-based analysis of 1282 antiretroviral therapy naive HIV-positive individuals aged 18 years and older in British Columbia who started triple-combination therapy between August 1996 and December 1999. Therapy use was estimated by dividing the number of months of medications dispensed by the number of months of follow-up. Intermittent therapy was defined as the participant having obtained less than 75% of their medication in the first 12 months.
Cumulative all-cause mortality rates from the start of triple drug antiretroviral therapy to 30 September 2000.
As of 30 September 2000, 106 subjects had died. Cumulative mortality was 3.9% (+/- 0.5%) at 12 months. In a multivariate model, after controlling for other variables that were significant in the univariate analyses each 100 cell decrement in baseline CD4 cell count and the intermittent use of antiretroviral drugs were associated with increased mortality with risk ratios of 1.31 [95% confidence interval (CI), 1.16-1.49; P