edoc-Server des Robert Koch-Instituts |
Publikationsart: | Veröffentlichter Artikel oder Aufsatz | |
Autor(en): | Inma Jarrin; Nikos Pantazis; Judith Dalmau; Andrew N. Phillips; Ashley Olson; Cristina Mussini; Faroudy Boufassa; Dominique Costagliola; Kholoud Porter; Juliá Blanco; Julia Del Amo; Javier Martinez-Picado | |
Titel: | Does rapid HIV disease progression prior to combination antiretroviral therapy hinder optimal CD4+ T-cell recovery once HIV-1 suppression is achieved? | |
Erschienen in: |
AIDS 29 (17)
, 2015
S. 2323-2333 | |
Verlag: | Wolters Kluwer | |
Verlags-URL: | http://journals.lww.com/aidsonline/Fulltext/2015/11130/Does_rapid_HIV_disease_progression_prior_to.14.aspx | |
DOI: | 10.1097/QAD.0000000000000805 | |
Veröffentlichung auf edoc: | 02.03.2016 | |
Status: | published | |
Volltext: |
![]() | (urn:nbn:de:0257-10043184) |
Schlagwörter (eng): | Humans, Female, Male, Adult, Middle Aged, Young Adult, Time Factors, Cohort Studies, CD4 Lymphocyte Count, HIV Infections/drug therapy, Viral Load, Antiretroviral Therapy Highly Active, CD4-Positive T-Lymphocytes/immunology, Disease Progression, Anti-Retroviral Agents/therapeutic use, HIV Infections/pathology, HIV-1/isolation & purification | |
Vorhaben/Arbeitsgruppe: | Robert Koch-Institut, Infektionsepidemiologie | |
Metadatenexport:
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Endnote Bibtex |
Abstract (eng): | |||||||||||||||||||||||||||||||||||||||||||||||||
Objective: This article compares trends in CD4+ T-cell recovery and proportions achieving optimal restoration (≥500 cells/μl) after viral suppression following combination antiretroviral therapy (cART) initiation between rapid and nonrapid progressors. Methods: We included HIV-1 seroconverters achieving viral suppression within 6 months of cART. Rapid progressors were individuals experiencing at least one CD4+ less than 200 cells/μl within 12 months of seroconverters before cART. We used piecewise linear mixed models and logistic regression for optimal restoration. Results: Of 4024 individuals, 294 (7.3%) were classified as rapid progressors. At the same CD4+ T-cell count at cART start (baseline), rapid progressors experienced faster CD4+ T-cell increases than nonrapid progressors in first month [difference (95% confidence interval) in mean increase/month (square root scale): 1.82 (1.61; 2.04)], which reversed to slightly slower increases in months 1–18 [−0.05 (−0.06; −0.03)] and no significant differences in 18–60 months [−0.003 (−0.01; 0.01)]. Percentage achieving optimal restoration was significantly lower for rapid progressors than nonrapid progressors at months 12 (29.2 vs. 62.5%) and 36 (47.1 vs. 72.4%) but not at month 60 (70.4 vs. 71.8%). These differences disappeared after adjusting for baseline CD4+ T-cell count: odds ratio (95% confidence interval) 0.86 (0.61; 1.20), 0.90 (0.38; 2.17) and 1.56 (0.55; 4.46) at months 12, 36 and 60, respectively. Conclusion: Among people on suppressive antiretroviral therapy, rapid progressors experience faster initial increases of CD4+ T-cell counts than nonrapid progressors, but are less likely to achieve optimal restoration during the first 36 months after cART, mainly because of lower CD4+ T-cell counts at cART initiation. | |||||||||||||||||||||||||||||||||||||||||||||||||
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