Factors associated with long‐term <scp>CD</scp>4 cell recovery in <scp>HIV</scp>‐infected patients on successful antiretroviral therapy

Collazos, Julio; Valle-Garay, Eulalia; Carton, JA; Montes, A. Hugo; Suárez-Zarracina, Tomás; Fuente, Belén de la; Asensi, Vı́ctor

doi:10.1111/hiv.12354

Cited by 5 publications

(1 citation statement)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Suboptimal immune recovery has long been proved to be associated with increased mortality and morbidity (26)(27)(28)(29). Risk factors for this suboptimal response to treatment include older age, lower nadir CD4 count, coinfection with HBV/HCV/CMV (30,31). The analysis of this cohort revealed factors related to suboptimal immune recovery less frequently reported in other studies, including BMI and fasting blood glucose.…”

Section: Resultsmentioning

confidence: 77%

Factors Associated with the Effectiveness of National Free Antiretroviral Treatment Program in HIV Infected Patients of Yi Nationality from Southwest China: Evidence from A Cohort Study to Provide Clues for Improvement

Chen¹,

Kang²,

Du³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Despite the current achievements of HIV management in the source-limited region of Liangshan Autonomous Prefecture, a small population remains with unsatisfactory virologic outcomes and suboptimal immune recovery. This cohort study aimed to identify potential risk factors of suboptimal clinical outcomes and to provide clues for improvement in people living with HIV (PLWH) from China’s National Free Antiretroviral Treatment Program (NFATP) in Zhaojue County, Liangshan Autonomous Prefecture of Yi nationality. Results: A total of 608 HIV infected adult patients in NFATP at the median age of 35(31, 40) were enrolled for analysis. During the 2.15(1.54, 4.00)-year follow-up, 502 (82.6%) patients achieved the viral load of <1000 copies/mL after over 6 months of antiretroviral therapy(ART). Among them, 398 (65.5%) cases achieved complete viral suppression with viral load <50 copies/mL while 104 (17.1%) cases remained with low level viremia (LLV, 50≤ viral load ≤1000 copies/mL). Patients with longer infection duration (OR =1.017 [95%CI: 1.002-1.033], p = 0.026), male gender (OR =1.632 [95%CI: 1.053-2.53], p = 0.028), positive hepatitis C virus antibody (OR =1.687 [95%CI: 1.093-2.604], p = 0.018) or infection through injecting drug use (IDU) (OR =1.584 [95%CI: 1.022-2.455], p = 0.04) were more likely to experience the undesirable outcome of LLV. Moreover, 254 (63.8%) of 398 patients with viral suppression achieved optimal immune recovery with the CD4 count ≥ 350 cells/μL. Patients with lower body mass index (BMI) (21.00±2.94 Kg/m 2 , OR=0.921 [95%CI: 0.854-0.994], p = 0.034) and higher fasting blood glucose (4.99±1.01 mmol/L, OR=1.343 [95%CI: 1.087-1.658], p = 0.006) were less likely to achieve the CD4 count ≥ 350 cells/μL after viral suppression. Conclusions: In this long-term cohort study of PLWH from Zhaojue County, Liangshan, most patients achieved virologic success on ART provided by NFATP but optimal immune recovery was yet to be expected. Approaches including strict control of illegal drug deal, patient education, and nutritional status management could be conducive to better prognosis for this population.

show abstract

Section: Resultsmentioning

confidence: 77%

Factors Associated with the Effectiveness of National Free Antiretroviral Treatment Program in HIV Infected Patients of Yi Nationality from Southwest China: Evidence from A Cohort Study to Provide Clues for Improvement

Chen¹,

Kang²,

Du³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

CD4+ T Cell Recovery and Hepatitis B Virus Coinfection in HIV-Infected Patients from Côte d'Ivoire Initiating Antiretroviral Therapy

Houghtaling

Moh

Chekaraou

et al. 2018

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

Immunorecovery could be attenuated in HIV-hepatitis B virus (HBV) coinfection versus HIV monoinfection during antiretroviral therapy (ART), yet, whether it also occurs in individuals from sub-Saharan Africa without severe comorbidities is unknown. In this study, 808 HIV-infected patients in Côte d'Ivoire initiating continuous ART were included. Six-month CD4+ count trajectories and the proportion reaching CD4+ T cell counts >350/mm, HIV-RNA <300 copies/mL, still alive and not lost to follow-up within 18 months ("optimal immunorecovery") were compared between coinfected groups. At inclusion, 80 (9.9%) patients were HIV-HBV coinfected, 40 (50.0%) of whom had high HBV-DNA viral load (VL) (>10 copies/mL). Coinfected patients with high HBV-DNA replication initiated ART with significantly lower median CD4+ T cell counts [216/mm, interquartile range (IQR) = 150-286] compared to coinfection with low HBV-DNA replication (268/mm, IQR = 178-375) or HIV monoinfection (257/mm, IQR = 194-329) (p = .003). These patients had significantly faster rates of CD4+ cell count increase from baseline after adjusting for baseline age, World Health Organization stage III/IV, and CD4+ cell counts (p = .04), yet, were not more likely to exhibit optimal immunorecovery (82.5% vs. 80.0% and 77.9%, respectively) (p = .8). In conclusion, change in CD4+ cell counts after ART-initiation was accelerated in coinfected patients with high HBV DNA VLs, but this did not lead to increased rates of optimal immunorecovery.

show abstract

HIV Treatment Outcomes After 10 years on ART in the TREAT Asia Observational Database and Australian HIV Observational Database

Jiamsakul,

Rupasinghe,

Woolley

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background: Increasing numbers of people with HIV have received prolonged antiretroviral therapy (ART). We assessed long-term immunological and survival outcomes among people with HIV from Asia (TAHOD) and Australia (AHOD). Methods: People with HIV receiving ART for ≥10 years were included. Factors associated with CD4 counts in years 11-15 of ART were analysed using repeated measure linear regression. Survival after 10 years was analysed using competing risk regression. Results: There were 7139 people included: 4867 (68%) from TAHOD and 2272 (32%) from AHOD. Higher CD4 after 10 years were observed if the nadir CD4 in the first decade was higher (CD4 (cells/µL) 101-200: difference=35, 95%CI 18, 51; >200: difference=125, 95%CI 107, 142) compared to ≤50. The same patterns were observed in those who achieved CD4 ≥500 cells/µL which subsequently decreased to <500 (difference=225, 95%CI 213, 236); or those who achieved and maintained CD4 ≥500 cells/µL (difference=402, 95%CI 384, 420), compared to always <500 in the previous decade. Prior protease inhibitor (PI) -based regimen (difference=-17, 95%CI -33, -1) compared to no PI, and previous treatment interruptions (TI) of 14 days to 3 months and >6 months were associated with lower CD4 counts after 10 years (difference = -38, 95%CI -62, -15; and difference=-44, 95%CI -61, -27, respectively) compared to no TI. The mortality rate was 1.04 per 100 person-years. Virological failure was associated with subsequent mortality (sub-hazard ratio=1.34, 95%CI 1.04, 1.71). Conclusions: Sustaining high CD4 levels and minimising TI has far-reaching benefits well beyond the first decade of ART.

show abstract

Factors associated with long‐term CD4 cell recovery in HIV‐infected patients on successful antiretroviral therapy

Abstract: In addition to the duration of HIV suppression, HIV-related diseases, HIV epidemiology, age, hepatitis C virus genotypes, and liver fibrosis were independently associated with long-term immunological recovery.

Cited by 5 publications

References 40 publications

Factors Associated with the Effectiveness of National Free Antiretroviral Treatment Program in HIV Infected Patients of Yi Nationality from Southwest China: Evidence from A Cohort Study to Provide Clues for Improvement

Factors Associated with the Effectiveness of National Free Antiretroviral Treatment Program in HIV Infected Patients of Yi Nationality from Southwest China: Evidence from A Cohort Study to Provide Clues for Improvement

CD4+ T Cell Recovery and Hepatitis B Virus Coinfection in HIV-Infected Patients from Côte d'Ivoire Initiating Antiretroviral Therapy

HIV Treatment Outcomes After 10 years on ART in the TREAT Asia Observational Database and Australian HIV Observational Database

Contact Info

Product

Resources

About