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Journal of Antimicrobial Chemotherapy (2001) 47, 371-375
© 2001 The British Society for Antimicrobial Chemotherapy

Leading article

Treatment comparisons in HIV infection: the benefits and limitations of observational cohort studies

Caroline A. Sabin,* and Andrew N. Phillips

Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London, UK

Background

Before the availability of highly active antiretroviral therapy, it was relatively easy to carry out randomized controlled trials (RCTs) of new antiretroviral (ARV) treatments for HIV infection that made use of clinical endpoints.1–4 As the rates of new AIDS-defining diseases and death were high, conclusions from RCTs could often be reached within a few years, a relatively short period compared with the many years currently required for such a trial. Only a limited number of ARV drugs were available, which had two major implications. First, specific treatment comparisons were fairly straightforward, and secondly, although patients did switch to new drugs,5 this occurred less frequently than today. However, as the number of ARV drugs grew, and patients were able to switch drugs more frequently, the results of long-term RCTs were sometimes thought to be irrelevant by the time they were published. For this reason, and because of a desire to rapidly . . . [Full Text of this Article]

Treatment comparisons in observational studies

When can we use observational cohort studies for treatment decisions?

Conclusions

Notes

References


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