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My name is Tristan Ferry. I'm working in Lyon,[France] in the infectious disease ward, and we presented a poster¹ about the incidence and risk factors for the occurrence of severe clinical events that are not related to AIDS, and not related to adverse drug events. So we demonstrate that we have a high incidence in our population. They are French patients that have been included in 1997, when they started HAART with a PI [protease inhibitor] regimen in France. And the incidence of these events were, of 10% of the patients here, it was three- to four-fold higher than AIDS events.

We demonstrate an association between immunosuppression and mainly uncontrolled viral load, with the occurrence of, for example, bacterial infections. This is quite new, and these results give us arguments against interruptions of HAART.

Could you give some specific infections that you saw?

Bacterial infections were mainly respiratory tract infections, and pneumonia.

I see on your list here, you have cancer-related events, as well. Could you describe them?

We recorded 68 cancers. They were mainly solid tumors, and carcinoma, mainly. But in this subgroup, we did not record an association between the uncontrolled viral load and the occurrence of these events.

Dr. Roy Steigbigel*: So you had a control group here?

No.

Dr. Roy Steigbigel: So you don't know whether this was excessive or not.

This table is just a description of each event.

Dr. Roy Steigbigel: Was there any association between cancer-related events and any other parameter that you measured?

When you look overall at these events, there is an association with immunosuppression. When we focus on the bacterial association, there is an association. But after, there is no association. There is too few a number.

Dr. Roy Steigbigel: Too few, yes. Because it would be interesting to know if immune activation, or something like that, would be associated here.

There was a tendency, but it was not significant. Maybe it was a higher number of patients. Yes. It's very interesting, because an uncontrolled viral load in the pathophysiology, that may ...

Dr. Roy Steigbigel: It would be interesting if you had a matched group of adults without HIV in the same community, to see if this ... What were the types of solid tumors? This was from France, was it?

Yes, yes, yes.

Dr. Roy Steigbigel: So you probably had a lot of lung cancer.

Mainly carcinoma. Lung cancer, but also digestive carcinoma.

Dr. Roy Steigbigel: Thank you very much.

Yes, thank you very much.

Footnotes

1. Ferry T, Raffi F, Collin F, et al, and the ANRS Co8 Study Group. Incidence and risk factors for the occurrence of non-AIDS-defining non-HAART-related severe clinical events in HIV-infected adults with long-term follow-up, Aproco-Copilote Cohort (ANRS CO8). In: Program and abstracts of the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 17-20, 2007; Chicago, Ill. Abstract H-1722.

To view study abstract, click here
To view study poster, click here

* Roy Steigbigel, Ph.D. is from Stony Brook University in New York