Long-term evolution of CD4+ cell count in patients under combined antiretroviral therapy

Pantazis, Nikos; Papastamopoulos, Vassilios; Paparizos, Vasilios; Metallidis, Simeon; Adamis, Georgios; Antoniadou, Anastasia; Psichogiou, Mina; Chini, Maria; Sambatakou, Helen; Sipsas, Nikolaos V.; Gogos, Charalambos; Chrysos, Georgios; Panagopoulos, Periklis; Κατσαρού, Όλγα; Gikas, Achilleas; Touloumi, Giota; Amacs,

doi:10.1097/qad.0000000000002248

Cited by 18 publications

(20 citation statements)

References 31 publications

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“…These disturbances are present despite the recovery of CD4 + T cell counts. These results agree with previous reports demonstrating the effectiveness of cART in recovering the CD4 + T cell counts in PLWH [ 20 ], which is highly related to the suppression of viral replication and with an early start of cART after serodiagnosis [ 21 , 22 ]. However, the lack of therapy-induced reconstitution of CD8 + T cells is associated with the activation/inflammatory burden [ 18 , 23 , 24 ], which is only partially modulated by cART [ 24 – 26 ].…”

Section: Discussionsupporting

confidence: 92%

Identification of CD8+ T cell subsets that normalize in early-treated people living with HIV receiving antiretroviral therapy

et al. 2022

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Background Although combined antiretroviral therapy (cART) has decreased the mortality associated with HIV infection, complete immune reconstitution is not achieved despite viral suppression. Alterations of CD8+ T cells and some of their subpopulations, such as interleukin (IL)-17-producing cells, are evidenced in treated individuals and are associated with systemic inflammation and adverse disease outcomes. We sought to evaluate if different CD8+ T cell subsets are differentially normalized during a clinical follow-up of people living with HIV (PLWH) receiving suppressive cART. Methods We explored the changes in the frequencies, activation/exhaustion phenotypes (HLA-DR, CD38, PD-1, and TIM-3), and function (total and HIV-specific cells expressing CD107a, perforin, granzyme B, interferon [IFN]-γ and IL-17) of CD8+ T cells from early-treated PLWH receiving cART in a 1-year follow-up, using a multidimensional flow cytometry approach. Results Despite continuous cART-induced viral suppression and recovery of CD4+ T cells, after a 1-year follow-up, the CD8+ T cell counts, CD4:CD8 ratio, PD-1 expression, and IL-17 production by CD8+ T cells exhibited incomplete normalization compared with seronegative controls. However, the proportion of CD8+ T cells with an exhausted phenotype (co-expressing PD-1 andTIM-3), and cells co-expressing cytotoxic molecules (Perforin and Granzyme B), reached normalization. Conclusions Although suppressive cART achieves normalization of CD4+ T cell counts, only particular subsets of CD8+ T cells are more rapidly normalized in PLWH receiving cART, which could be routinely used as biomarkers for therapy efficiency in these patients.

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Section: Discussionsupporting

confidence: 92%

Identification of CD8+ T cell subsets that normalize in early-treated people living with HIV receiving antiretroviral therapy

et al. 2022

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“…In contrast, some studies suggested that HIV patients with low pre-ART CD4 + T-cell count indicated a rapid CD4 + T-cell recovery, and higher long term mean CD4 + T-cells in post-ART [11,14,30,35]. Unlike the above ndings, few studies indicated that the baseline CD4 + T-cell count have no signi cant association with immune recovery following ART administration [27,51]. The variation might be due to the difference in duration of ART initiation time (early Vs late), lower rate of AIDS events, and higher rate of immune reconstitution system compared to among patients with low CD4 T-cell at ART initiation [18].…”

Section: Discussionmentioning

confidence: 95%

Pattern of CD4 + T cell recovery and determinants of HIV infected individuals receiving highly active antiretroviral treatment in Mekelle Hospital, Tigray Northern Ethiopia; Retrospective study

Weldemhret

Desta

Bekurtsion

et al. 2023

Preprint

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Background: With the advent of antiretroviral treatment, HIV related morbidity and mortality have tremendously decreased. However, some HIV patients on ART don’t optimally respond to the ART regimen to restore the immunity. This study was aimed to determine the pattern of CD4+ T cell recovery and determinants of HIV infected individuals receiving the ART in Mekelle Hospital, Tigray northern Ethiopia. Methods: A hospital based retrospective cross-sectional study was conducted from January, 2010 to August, July 2020 among HIV positive individuals on ART follow up. Data were collected using pre-tested structured questionnaire by trained data collector. Statistical analysis was performed using SPSS V. 20. Bivariate and multivariate analyses were performed to identify the possible predictors for immune reconstitution after ART administration. P-values < 0.05 was considered statistically significant. Results: Of the total 424 study participants, 248(58%) were females. The mean age of the study participants was 37+9 (mean + sd). The median time of ART follow up was 60 (IQR: 36-84) months and the recent median CD4+ T-cell count was 388 (IQR; 254-527) cells/µl. The CD4 cell count increment compared to pre-ART was 166 cells/µl of blood. Age ranges 25-34 years (AOR 2.62, 95%CI: 0.82-8.35), CD4+ T-cell count >200 cells/µl at baseline (AOR 3.53, 95%CI: 2.23-5.58), duration of ART follow up at 12, 48 and 49 and above months respectively (AOR 8.053, 95%CI:1.45-44.84; 4.82, 95%CI:1.16-20.11); and (AOR 6.36, 95%CI:1.63-24.77), and TDF-3CT-Efv ART regimen combination (AOR 2.29, 95%CI:1.32-3.97) were found predictors significantly associated with CD4+ T-cell recovery after long term ART uptake, which characterized by >350 cells/µl increments. Conclusions: The immune restoration of HIV positive individuals depends on the length of ART follow up time and CD4+ T-cell level during the initiation. Moreover, individuals who were taking TDF-3CT-Efv ART drug combination demonstrated a rapid CD4+ T-cell restoration than these who were taking other ART drug regimens.

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“…The percentage of undiagnosed PWH was provided by the Greek National Public Health Organization (NPHO) estimated by applying the ECDC tool to surveillance data [20,23]. All the remaining estimates were obtained using data from the Athens Multicenter AIDS Cohort Study (AMACS) [24,25]. AMACS is a collaborative, population-based cohort study initiated in 1996.…”

Section: Data Sourcesmentioning

confidence: 99%

HIV continuum of care: bridging cross-sectional and longitudinal analyses

Touloumi

Thomadakis

Pantazis

et al. 2021

Aids

Self Cite

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Objective:The aim of this study was to propose a unified continuum-of-care (CoC) analysis combining cross-sectional and longitudinal elements, incorporating time spent between stages.Design:The established 90-90-90 target follows a cross-sectional four-stage CoC analysis, lacking information on timing of diagnosis, antiretroviral therapy (ART) initiation, and viral suppression durability.Methods:Data were derived from the Athens Multicenter AIDS Cohort Study (AMACS). In the cross-sectional CoC, we added stratification of diagnosed people with HIV (PWH) by estimated time from infection to diagnosis; of those who ever initiated ART or achieved viral suppression by corresponding current status (in 2018); and cumulative incidence function (CIF) of ART initiation and viral suppression, treating loss-to-follow-up (LTFU) as competing event. Viral suppression was defined as viral load less than 500 copies/ml. Viral suppression durability was assessed by the CIF of viral load rebound.Findings:About 89.1% of PWH in 2018 were diagnosed (range of diagnoses: 1980–2018). Median time to diagnosis was 3.5 years (IQR: 1.1–7.0). Among diagnosed, 89.1% were ever treated, of whom 86.7% remained on ART. CIF of ART initiation and LTFU before ART initiation were 80.9 and 6.0% at 5 years since diagnosis, respectively. Among treated, 89.4% achieved viral suppression, of whom 87.4% were currently virally suppressed. The CIF of viral load rebound was 24.2% at 5 years since first viral suppression but substantially reduced in more recent years.Interpretation:The proposed analysis highlights time gaps in CoC not evident by the standard cross-sectional approach. Our analysis highlights the need for early diagnosis and identifies late presenters as a key population for interventions that could decrease gaps in the CoC.

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Long-term evolution of CD4+ cell count in patients under combined antiretroviral therapy

Cited by 18 publications

References 31 publications

Identification of CD8+ T cell subsets that normalize in early-treated people living with HIV receiving antiretroviral therapy

Identification of CD8+ T cell subsets that normalize in early-treated people living with HIV receiving antiretroviral therapy

Pattern of CD4 + T cell recovery and determinants of HIV infected individuals receiving highly active antiretroviral treatment in Mekelle Hospital, Tigray Northern Ethiopia; Retrospective study

HIV continuum of care: bridging cross-sectional and longitudinal analyses

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