[Skip to Content]
[Skip to Content Landing]
Citations 0
June 17, 1998

Antiretroviral Therapy and Improving AIDS Survival—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(23):1874-1875. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-23-jbk0617

In Reply.— Dr De Luca and colleagues raise a number of issues. As reported in our article, this population-based study demonstrated that HIV-infected individuals who initially received therapy regimens that included stavudine or lamivudine had significantly lower mortality and longer AIDS-free survival than those who initially received combination and monotherapy regimens limited to zidovudine, didanosine, and zalcitabine. We have also clearly shown in our article that the extensive use of monotherapy in ERA-I treatment could not explain the difference in mortality and AIDS-free survival between ERA-I and ERA-II treatments. In fact, we reported the relevant analyses excluding participants treated with monotherapy regimens in ERA-I with no appreciable change in results. Retaining monotherapy-treated subjects in ERA-II represents a conservative bias, based on our current understanding of the impact of mono-dual nucleoside therapies.1,2 We have repeated our multivariate analyses excluding all subjects taking any monotherapy in ERA-I and II. After adjusting for other prognostic variables (use of Pneumocystis carinii pneumonia and Mycobacterium avium prophylaxis, CD4 cell count, sex, and age), ERA-I subjects were 1.73 times (95% CI, 1.07-2.80; P=.02) more likely to die and 2.48 times (95% CI, 1.51-4.05; P< .001) more likely to progress to AIDS or die than ERA-II participants.

First Page Preview View Large
First page PDF preview
First page PDF preview