OBJECTIVE: CD4 cell count changes in therapy-naive patients were investigated during 7 years of highly active antiretroviral therapy (HAART) in an observational cohort. METHODS: Three endpoints were studied: (1) time to >or=800 CD4 cells/mm in 5299 therapy-naive patients starting HAART, (2) CD4 cell count changes during 7 years of uninterrupted HAART in a subset of 544 patients, and (3) reaching a plateau in CD4 cell restoration after 5 years of HAART in 366 virologically suppressed patients. RESULTS: Among patients with <50, 50 to 200, 200 to 350, 350 to 500, and >or=500 CD4 cells/mm at baseline, respectively, 20%, 26%, 46%, 73%, and 87% reached >or=800 CD4 cells/mm within 7 years of starting HAART. Periods with HIV RNA levels >500 copies/mL and age >or=50 years were associated with lesser increases in CD4 cell counts between 6 months and 7 years. Having reached >or=800 CD4 cells/mm at 5 years, age >or=50 years, and >or=1 HIV RNA measurement >1000 copies/mL between 5 and 7 years were associated with a plateau in CD4 cell restoration. CONCLUSIONS: Restoration to CD4 cell counts >or=800 cells/mm is feasible within 7 years of HAART in most HIV-infected patients starting with >or=350 cells/mm and achieving sufficient suppression of viral replication. Particularly in patients >or=50 years of age, it may be beneficial to start earlier than current guidelines recommend.
OBJECTIVE:CD4 cell count changes in therapy-naive patients were investigated during 7 years of highly active antiretroviral therapy (HAART) in an observational cohort. METHODS: Three endpoints were studied: (1) time to >or=800 CD4 cells/mm in 5299 therapy-naive patients starting HAART, (2) CD4 cell count changes during 7 years of uninterrupted HAART in a subset of 544 patients, and (3) reaching a plateau in CD4 cell restoration after 5 years of HAART in 366 virologically suppressed patients. RESULTS: Among patients with <50, 50 to 200, 200 to 350, 350 to 500, and >or=500 CD4 cells/mm at baseline, respectively, 20%, 26%, 46%, 73%, and 87% reached >or=800 CD4 cells/mm within 7 years of starting HAART. Periods with HIV RNA levels >500 copies/mL and age >or=50 years were associated with lesser increases in CD4 cell counts between 6 months and 7 years. Having reached >or=800 CD4 cells/mm at 5 years, age >or=50 years, and >or=1 HIV RNA measurement >1000 copies/mL between 5 and 7 years were associated with a plateau in CD4 cell restoration. CONCLUSIONS: Restoration to CD4 cell counts >or=800 cells/mm is feasible within 7 years of HAART in most HIV-infectedpatients starting with >or=350 cells/mm and achieving sufficient suppression of viral replication. Particularly in patients >or=50 years of age, it may be beneficial to start earlier than current guidelines recommend.
Authors: Jessie K Edwards; Stephen R Cole; Jeffrey N Martin; Richard Moore; W Christopher Mathews; Mari Kitahata; Joseph J Eron; Michael Saag; Michael J Mugavero Journal: Clin Infect Dis Date: 2015-04-01 Impact factor: 9.079
Authors: Colleen F Kelley; Christina M R Kitchen; Peter W Hunt; Benigno Rodriguez; Frederick M Hecht; Mari Kitahata; Heide M Crane; James Willig; Michael Mugavero; Michael Saag; Jeffrey N Martin; Steven G Deeks Journal: Clin Infect Dis Date: 2009-03-15 Impact factor: 9.079
Authors: S T Wright; K Petoumenos; M Boyd; A Carr; S Downing; C C O'Connor; M Grotowski; M G Law Journal: HIV Med Date: 2012-10-04 Impact factor: 3.180
Authors: Alan R Lifson; Elizabeth M Krantz; Lynn E Eberly; Matthew J Dolan; Vincent C Marconi; Amy C Weintrob; Nancy F Crum-Cianflone; Anuradha Ganesan; Patricia L Grambsch; Brian K Agan Journal: AIDS Res Ther Date: 2011-01-18 Impact factor: 2.250