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The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Early Antiretroviral Therapy Reduces AIDS Progression/Death in Individuals with Acute Opportunistic Infections: A Multicenter Randomized Strategy Trial

Open access
Zolopa, Andrew R., Andersen, Janet, Komarow, Lauren, Sanne, Ian, Sanchez, Alejandro, Hogg, Evelyn, Suckow, Carol, Powderly, William, for the ACTG A5164 study team·2009·PLoS ONE
DOI 10.1371/journal.pone.0005575
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Abstract

BACKGROUND: Optimal timing of ART initiation for individuals presenting with AIDS-related OIs has not been defined. METHODS AND FINDINGS: A5164 was a randomized strategy trial of "early ART"--given within 14 days of starting acute OI treatment versus "deferred ART"--given after acute OI treatment is completed. Randomization was stratified by presenting OI and entry CD4 count. The primary week 48 endpoint was 3-level ordered categorical variable: 1. Death/AIDS progression; 2. No progression with incomplete viral suppression (ie HIV viral load (VL) >or=50 copies/ml); 3. No progression with optimal viral suppression (ie HIV VL <50 copies/ml). Secondary endpoints included: AIDS progression/death; plasma HIV RNA and CD4 responses and safety parameters including IRIS. 282 subjects were evaluable; 141 per arm. Entry OIs included Pneumocytis jirovecii pneumonia 63%, cryptococcal meningitis 12%, and bacterial infections 12%. The early and deferred arms started ART a median of 12 and 45 days after start of OI treatment, respectively. THE DIFFERENCE IN THE PRIMARY ENDPOINT DID NOT REACH STATISTICAL SIGNIFICANCE: AIDS progression/death was seen in 20 (14%) vs. 34 (24%); whereas no progression but with incomplete viral suppression was seen in 54 (38%) vs. 44 (31%); and no progression with optimal viral suppression in 67 (48%) vs 63 (45%) in the early vs. deferred arm, respectively (p = 0.22). However, the early ART arm had fewer AIDS progression/deaths (OR = 0.51; 95% CI = 0.27-0.94) and a longer time to AIDS progression/death (stratified HR = 0.53; 95% CI = 0.30-0.92). The early ART had shorter time to achieving a CD4 count above 50 cells/mL (p<0.001) and no increase in adverse events. CONCLUSIONS: Early ART resulted in less AIDS progression/death with no increase in adverse events or loss of virologic response compared to deferred ART. These results support the early initiation of ART in patients presenting with acute AIDS-related OIs, absent major contraindications. TRIAL REGISTRATION: ClinicalTrials.gov NCT00055120.

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Metadata

Authors
Zolopa, A. R., Andersen, J., Komarow, L., Sanne, I., Sanchez, A., Hogg, E., Suckow, C., Powderly, W., & for the ACTG A5164 study team
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2009-05-18
Volume
4
Issue
5
Pages
e5575
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0005575
OpenAlex
W2130316654
Cited by
567
References
18
FWCI
38.95
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: Early Antiretroviral Therapy Reduces AIDS Progression/Death in Individuals with Acute Opportunistic Infections: A Multicenter Randomized Strategy Trial. https://app.cochat.ai/papers/10.1371/journal.pone.0005575
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Zolopa, A. R., Andersen, J., Komarow, L., Sanne, I., Sanchez, A., Hogg, E., Suckow, C., Powderly, W., & for the ACTG A5164 study team. (2009). Early Antiretroviral Therapy Reduces AIDS Progression/Death in Individuals with Acute Opportunistic Infections: A Multicenter Randomized Strategy Trial. PLoS ONE. https://doi.org/10.1371/journal.pone.0005575

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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