BACKGROUND: Factors that determine the immunological response to highly active antiretroviral therapy (HAART) are poorly defined. OBJECTIVE: Our aim was to investigate predictors of immunological failure after initial CD4(+) response. METHODS: Data were from EuroSIDA, a prospective, international, observational human immunodeficiency virus (HIV) type 1 cohort. RESULTS: Of 2347 patients with an increase in CD4(+) cell count >or=100 cells/microL within 6-12 months of the initiation of HAART, 550 (23%) subsequently experienced immunological failure (CD4(+) count less than or equal to the pre-HAART value). The incidence of failure was 11.6 incidences/100 person-years of follow-up (95% confidence interval [CI], 10.2-13.4) during the first 12 months and decreased significantly over time (P<.0001). Independent predictors of immunological failure were pre-HAART CD4(+) cell count (per 50% higher; relative hazard [RH], 2.05; 95% CI, 1.83-2.31; P<.0001), time-updated virus load (per 1 log(10) higher; RH, 1.77; 95% CI, 1.64-1.92; P<.0001), and HIV-1 risk behavior (P=.047 for a global comparison of risk groups). CONCLUSION: The risk of immunological failure in patients with an immunological response to HAART diminishes with a longer time receiving treatment and is associated with pretreatment CD4(+) cell count, ongoing viral replication, and intravenous drug use.
BACKGROUND: Factors that determine the immunological response to highly active antiretroviral therapy (HAART) are poorly defined. OBJECTIVE: Our aim was to investigate predictors of immunological failure after initial CD4(+) response. METHODS: Data were from EuroSIDA, a prospective, international, observational human immunodeficiency virus (HIV) type 1 cohort. RESULTS: Of 2347 patients with an increase in CD4(+) cell count >or=100 cells/microL within 6-12 months of the initiation of HAART, 550 (23%) subsequently experienced immunological failure (CD4(+) count less than or equal to the pre-HAART value). The incidence of failure was 11.6 incidences/100 person-years of follow-up (95% confidence interval [CI], 10.2-13.4) during the first 12 months and decreased significantly over time (P<.0001). Independent predictors of immunological failure were pre-HAART CD4(+) cell count (per 50% higher; relative hazard [RH], 2.05; 95% CI, 1.83-2.31; P<.0001), time-updated virus load (per 1 log(10) higher; RH, 1.77; 95% CI, 1.64-1.92; P<.0001), and HIV-1 risk behavior (P=.047 for a global comparison of risk groups). CONCLUSION: The risk of immunological failure in patients with an immunological response to HAART diminishes with a longer time receiving treatment and is associated with pretreatment CD4(+) cell count, ongoing viral replication, and intravenous drug use.
Authors: Liselotte van Asten; Robert Zangerle; Ildefonso Hernández Aguado; Faroudy Boufassa; Barbara Broers; Raymond P Brettle; J Roy Robertson; Jim McMenamin; Roel A Coutinho; Maria Prins Journal: Eur J Epidemiol Date: 2005 Impact factor: 8.082
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Authors: A Antinori; A Ammassari; C Torti; P Marconi; M Andreoni; G Angarano; S Bonora; A Castagna; R Cauda; M Clerici; A d'Arminio Monforte; A De Luca; G Di Perri; M Galli; E Girardi; A Gori; A Lazzarin; S Lo Caputo; F Mazzotta; F Montella; C Mussini; C F Perno; M Puoti; G Rizzardini; S Rusconi; V Vullo; G Carosi Journal: Infection Date: 2009-05-28 Impact factor: 3.553
Authors: Mari M Kitahata; Benigno Rodriguez; Richard Haubrich; Stephen Boswell; W Christopher Mathews; Michael M Lederman; William B Lober; Stephen E Van Rompaey; Heidi M Crane; Richard D Moore; Michael Bertram; James O Kahn; Michael S Saag Journal: Int J Epidemiol Date: 2008-02-08 Impact factor: 7.196
Authors: Abraham M Siika; Constantin T Yiannoutsos; Kara K Wools-Kaloustian; Beverly S Musick; Ann W Mwangi; Lameck O Diero; Sylvester N Kimaiyo; William M Tierney; Jane E Carter Journal: PLoS One Date: 2013-01-02 Impact factor: 3.240