To assess HIV disease development we used knotted splines and mixed
May 20, 2017
To assess HIV disease development we used knotted splines and mixed effect models to compare the post delivery slope of the CD4+ lymphocyte counts CD4+ lymphocyte percents and HIV RNA levels between women continuing or stopping ART at delivery using [18 19 Rates of development of new CDC class B or C events were compared using Cox proportional hazard models . described . Plasma HIV-1 RNA was measured in stored specimens using the Roche Amplicor HIV-1 Monitor Test (Roche Diagnostic Systems Branchburg NJ) as described in . Specimens were assayed for routine metabolic analytes (total URB597 cholesterol high-density lipoprotein (HDL) cholesterol triglycerides high sensitivity URB597 C-reactive protein (hsCRP)) at Quest Diagnostics Baltimore MD and for specialty analytes (leptin lipoprotein-associated phospholipase A2 (Lp-PLA2) interleukin 6 (IL-6)) at Quest Diagnostics Nichols Institute San Juan Capistrano CA. Aliquots of frozen serum were LASS2 antibody shipped to Quest Diagnostics on dry ice for batch testing of each analyte. Low-density lipoprotein cholesterol (LDL) was calculated using the Friedewald Equation for those samples exhibiting triglyceride values below 400 mg/dL. The laboratory utilized the FDA-cleared Cholesterol Esterase/Oxidase method of Olympus (Olympus America Inc. Melville NY) on an automated testing platform for total cholesterol quantitation. For HDL cholesterol the laboratory utilized the FDA-cleared HDL-Cholesterol Plus 2nd Generation assay from Roche Diagnostics (Indianapolis IN) on an automated testing platform. For triglyceride quantitation the laboratory utilized the FDA-cleared Triglyceride reagents from Olympus on an computerized testing system. Serum high level of sensitivity CRP levels had been assessed using the FDA-cleared computerized BN II in vitro diagnostic program (Dade Behring Inc. Newark DE). A particle can be used by This technique enhanced immunonephelometric assay having a level of sensitivity of 0.2 mg/L. Leptin was measured using the extensive study ONLY USE Human being Leptin RIA Package from Linco Study Inc. (St. Charles Missouri). This technique can be a competitive radioimmunoassay that utilizes a set focus of Iodine-125-tagged human being leptin tracer antigen having a continuous dilution of human being leptin antiserum. The focus of unknown human being leptin in the analysis subject’s examples is set against a calibration curve that’s URB597 setup with each assay operate that includes raising concentrations of regular unlabeled human being leptin antigen. Human being IL-6 was measured using the extensive study ONLY USE Quantikine HS Human being IL-6 Immunoassay package from R&D Systems Inc. (Minneapolis MN). This assay utilizes a quantitative sandwich enzyme immunoassay strategy to estimation the focus of IL-6 in serum specimens. Lp-PLA2 was assessed using the FDA-approved PLAC check package from diaDexus (South SAN FRANCISCO BAY AREA CA). 3 Outcomes From the 206 ladies eligible for addition 147 continuing therapy after delivery and 59 discontinued. An evaluation of both organizations is demonstrated in Desk 1. Women preventing therapy at delivery had been slightly young and got higher Compact disc4+ lymphocyte matters than ladies continuing therapy however the organizations were identical in competition/ethnicity gestational age URB597 group at enrollment background of course B or C disease and HIV RNA amounts. Desk 1 Baseline features of ladies contained in the research according to position of antiretroviral therapy after delivery. ZDV monotherapy was utilized by 103 ladies during being pregnant 41 of whom ceased therapy at delivery and 62 of whom continuing. Three additional ladies received monotherapy with additional medicines one with nevirapine and two with didanosine. A hundred ladies took several antiretroviral medicines during being pregnant 18 of whom ceased therapy at delivery and 82 of whom continuing. Of the ladies on mixture therapy 27 got two NRTI’s two got triple NRTI regimens including abacavir 11 got two NRTI’s plus an NNRTI 55 got two NRTI’s with a number of PI’s four got triple course regimens and one got a regimen of 1 NRTI with an NNRTI. We likened the chance of HIV disease development between ladies who ceased and women who continued therapy after delivery in several ways. The slopes of CD4+ lymphocyte counts and percentages and of HIV RNA levels were compared between two and six months and six and twelve months postpartum to assess for “rebound changes” after stopping therapy. As shown in Figure 1 and Table 2 the rate of change in CD4+ cell measures and HIV RNA was not significantly different between the two groups. To evaluate further by type of therapy during.