Research to date has produced conflicting findings on the influence of sex/gender and route of HIV transmission on the initial prescription of combination antiretroviral therapy (HAART) and its biological and clinical efficacy.

As reported in the November 2006 issue of HIV Medicine, researchers conducted a cohort study involving 5735 patients at 62 French hospitals enrolled between January 1997 and December 2001 who did not start HAART or develop a stage C HIV-related event during the first 3 months after inclusion.

The investigators used Cox proportional hazards models to assess whether gender or HIV transmission route influenced the timing of elective HAART initiation and the clinical and biological response to treatment.

Results

In a multivariate analysis, the interval between enrollment and HAART initiation did not differ by gender.

This interval was shorter in homosexual men compared with other transmission groups.

CD4 cell counts at treatment initiation were also higher in the homosexual group.

Immunological and virological response to treatment did not differ according to gender, but was better in homosexual patients compared with those in other transmission categories.

Injection drug users had the weakest immunological/virological responses.

Clinical outcome was not related to gender or HIV transmission category.

Conclusion

"The interval between diagnosis of HIV-1 infection and elective HAART initiation was not influenced by gender," the authors concluded. "However, homosexual patients had higher CD4 cell counts than other patients at treatment initiation, and also had better immuno-virological responses."

12/08/06

Reference
L Fardet, M Mary-Krause, I Heard, and others. Influence of gender and HIV transmission group on initial highly active antiretroviral therapy prescription and treatment response. HIV Medicine 7(8): 520-529. November 2006.