Background: The extent and duration of long-term recovery of CD4 count, CD4 percentage (CD4%), and CD4/CD8 ratio after initiation of combination antiretroviral therapy (cART) in patients with a suppressed viral load (VL) are largely unknown. Methods: Patients infected with human immunodeficiency virus type 1 who started cART between January 2004 and January 2012 and showed persistent viral suppression (VL, <200 copies/mL) for ≥4 years were followed up at the AIDS Clinical Center in Tokyo. Change point analysis was used to determine the time point when CD4 count recovery shows a plateau, and a linear mixed model was applied to estimate the CD4 count at this change point. Results: Data were analyzed from 752 patients (93% male; median age, 38 years; median baseline CD4 cell count, 172/µL [interquartile range CD4%, 13.8%]; CD4/CD8 ratio, 0.23). The median follow-up period was 81.2 months, and 91 patients (12.1%) were followed up for >10 years. Change point analysis showed that CD4 count, CD4%, and CD4/CD8 ratio continued to increase until 78.6, 62.2, and 64.3 months, respectively, with adjusted means of 590/µL (95% confidence interval, 29.5%, and 0.89, respectively, at the change point. Although CD4 counts ≥500/μL were achieved in 73.8% of the study patients, they were not achieved in 48.2% of those with a baseline CD4 count <100/μL. Neither the CD4% nor the CD4/CD8 ratio were normalized in a majority of patients. Conclusions: The results showed lack of normalization of CD4 count, CD4%, and CD4/CD8 ratio to the levels seen in healthy individuals even after long-term successful cART in patients with a suppressed VL.
Background: The extent and duration of long-term recovery of CD4 count, CD4 percentage (CD4%), and CD4/CD8 ratio after initiation of combination antiretroviral therapy (cART) in patients with a suppressed viral load (VL) are largely unknown. Methods:Patientsinfected with human immunodeficiency virus type 1 who started cART between January 2004 and January 2012 and showed persistent viral suppression (VL, <200 copies/mL) for ≥4 years were followed up at the AIDS Clinical Center in Tokyo. Change point analysis was used to determine the time point when CD4 count recovery shows a plateau, and a linear mixed model was applied to estimate the CD4 count at this change point. Results: Data were analyzed from 752 patients (93% male; median age, 38 years; median baseline CD4 cell count, 172/µL [interquartile range CD4%, 13.8%]; CD4/CD8 ratio, 0.23). The median follow-up period was 81.2 months, and 91 patients (12.1%) were followed up for >10 years. Change point analysis showed that CD4 count, CD4%, and CD4/CD8 ratio continued to increase until 78.6, 62.2, and 64.3 months, respectively, with adjusted means of 590/µL (95% confidence interval, 29.5%, and 0.89, respectively, at the change point. Although CD4 counts ≥500/μL were achieved in 73.8% of the study patients, they were not achieved in 48.2% of those with a baseline CD4 count <100/μL. Neither the CD4% nor the CD4/CD8 ratio were normalized in a majority of patients. Conclusions: The results showed lack of normalization of CD4 count, CD4%, and CD4/CD8 ratio to the levels seen in healthy individuals even after long-term successful cART in patients with a suppressed VL.
Authors: Cristina B Sanger; Yiwei Xu; Evie Carchman; Elise H Lawson; Charles P Heise; Rob Striker; Corrine I Voils Journal: Dis Colon Rectum Date: 2021-07-01 Impact factor: 4.412
Authors: Lourdes Domínguez-Domínguez; Marta Rava; José Antonio Iribarren; Santiago Moreno; Otilia Bisbal; Luis Lopez-Cortés; Joaquín Portilla; Daniel Podzamczer; Julián Olalla; Daniel Fuster; Rafael Rubio; Inmaculada Jarrín Journal: BMC Infect Dis Date: 2022-04-15 Impact factor: 3.667
Authors: Carl J Fichtenbaum; Heather J Ribaudo; Jorge Leon-Cruz; Edgar T Overton; Markella V Zanni; Carlos D Malvestutto; Judith A Aberg; Emma M Kileel; Kathleen V Fitch; Marije Van Schalkwyk; Nagalingeswaran Kumarasamy; Esteban Martinez; Breno Riegel Santos; Yvetot Joseph; Janet Lo; Sue Siminski; Kathleen Melbourne; Craig A Sponseller; Patrice Desvigne-Nickens; Gerald S Bloomfield; Judith S Currier; Udo Hoffmann; Pamela S Douglas; Steven K Grinspoon Journal: J Infect Dis Date: 2020-07-09 Impact factor: 7.759
Authors: Birgitte Stiksrud; Hans C D Aass; Kristina B Lorvik; Thor Ueland; Marius Trøseid; Anne M Dyrhol-Riise Journal: AIDS Date: 2019-06-01 Impact factor: 4.177
Authors: Lucia Taramasso; Antonio Di Biagio; Niccolò Riccardi; Federica Briano; Elisa Di Filippo; Laura Comi; Sara Mora; Mauro Giacomini; Andrea Gori; Franco Maggiolo Journal: PLoS One Date: 2019-10-11 Impact factor: 3.240