Normalisation of CD4 counts in patients with HIV-1 infection and maximum virological suppression who are taking combination antiretroviral therapy: an observational cohort study

Mocroft, Amanda; Phillips, Andrew; Gatell, José M.; Ledergerber, Bruno; Fisher, Martin; Clumeck, Nathan; Losso, M.; Lazzarin, Adriano; Fätkenheuer, Gerd; Lundgren, Jens D

doi:10.1016/s0140-6736(07)60948-9

Cited by 222 publications

(168 citation statements)

References 37 publications

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“…The temporal association between recovery of AM proteolysis and duration of ART is consistent with previous studies that profiled the kinetics of peripheral blood CD4 1 T-cell count recovery during ART (7,8). AM are key effectors of innate immunity in the lung (15) and constitute over 90% of immune cells in BAL from healthy HIV-uninfected adults (16).…”

Section: Discussionsupporting

confidence: 87%

“…Several previous studies have profiled the kinetics of peripheral blood CD4 1 T-cell count as a surrogate marker of immune recovery during ART. These studies reported a rapid increase in CD4 1 T cells during the first few months of treatment, followed by a more gradual increase during the subsequent months or years before reaching a plateau after approximately 4 years of ART (7,8). ART-associated immune recovery reduces morbidity and mortality caused by HIVrelated opportunistic infections (9).…”

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confidence: 99%

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Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria

Jambo

Banda

Afran

et al. 2014

Am J Respir Crit Care Med

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Rationale: HIV-infected persons on antiretroviral therapy (ART) remain at higher risk of pulmonary tuberculosis (TB) than HIV-uninfected individuals. This increased susceptibility may be caused by impairment of alveolar macrophage (AM) function and/or mycobacteria-specific alveolar CD4 1 T-cell responses observed in HIV-infected ART-naive adults.Objectives: To determine whether ART was associated with improvement in both AM function, assessed by phagosomal proteolysis, and alveolar CD4 1 T-cell responses to Mycobacterium in HIV-infected individuals.Methods: Peripheral blood was drawn and bronchoalveolar lavage (BAL) performed on healthy, 35 HIV-uninfected, 25 HIV-infected ART-naive, and 50 HIV-infected ART-treated asymptomatic adults. Phagosomal proteolysis of AM was assessed with fluorogenic beads. Mycobacteria-specific CD4 1 T-cell responses were measured by intracellular cytokine staining.Measurements and Main Results: HIV-infected adults on ART exhibited lower plasma HIV viral load and higher blood CD4 1 T-cell count than ART-naive adults. AM proteolysis and total mycobacteria-specific Th1 CD4 1 T-cell responses in individuals on ART for greater than or equal to 4 years were similar to HIVuninfected control subjects but those on ART for less than 4 years had impaired responses. Total influenza-specific alveolar Th1 CD4 1 Tcell responses were intact in all individuals receiving ART. In contrast, BAL and blood mycobacteria-specific polyfunctional CD4 1 T-cell responses were impaired in adults on ART irrespective of duration.Conclusions: AM and mycobacteria-specific alveolar CD4 1 T-cell responses in HIV-infected adults on ART for less than 4 years are impaired and may partly explain the high risk of TB in HIV-infected individuals on ART. Strategies to augment ART to improve lung immune cell function and reduce the high incidence of TB in HIVinfected adults who initiate ART should be investigated.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria

Jambo

Banda

Afran

et al. 2014

Am J Respir Crit Care Med

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“…Moreover, the risk for HCC in HIV-HCV coinfected patients is unlikely to be modified by the use of HAART; therefore, treatment of HCV infection in HIVinfected patients at risk for cirrhosis is strongly recommended [14]. In addition, routine screening of persons with HCV-related cirrhosis by serial liver imaging and serum ␣-fetoprotein measurement is recommended [15].…”

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confidence: 99%

Sorafenib Therapy for Hepatocellular Carcinoma in an HIV–HCV Coinfected Patient: A Case Report

et al. 2010

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Background/Aims. HIV and hepatitis C virus (HCV) share common modes of transmission, resulting in about 33% incidence of coinfection among people infected with HIV. The survival benefit from highly effective antiretroviral therapy (HAART) for HIV infection is resulting in an increased incidence of hepatocellular carcinoma (HCC) in this population. There are no reports to date regarding the coadministration of HAART and sorafenib for hepatocellular carcinoma.Methods. We report the case of a 42-year-old male patient coinfected with HIV and HCV who developed advanced HCC not amenable to curative therapy. The patient was treated with sorafenib, an oral multikinase inhibitor shown to lead to a longer median survival time and time to progression in patients with advanced HCC.

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“…[15][16][17][18][19] eventually to zero, but with increasing mortality and incidence of opportunistic infections, including tuberculosis. 20,21 Recent studies suggest that combination therapy for HIV is most effective during acute phase of infection. 22,23 A study from swiss COHORT stated that interruption from antiretroviral therapy was associated with decrease in CD4+ count, suggesting that adherence to ART not the viremia is most important in predicting the change in CD4+ cell count.…”

Section: Resultsmentioning

confidence: 99%

To study the effect of various combinations of haart in CD4+ cell count in HIV patient at RIMS, Ranchi Art Centre

Mahato

Keshri

Kumar

et al. 2017

Int J Basic Clin Pharmacol

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Background: India has the third largest HIV epidemic in the world. In 2013, HIV prevalence in India was an estimated 0.3%, an estimated 130,000 people died from AIDS-related illnesses. Overall, India’s HIV epidemic is slowing down, with a 19% decline in new HIV infections (130,000 in 2013), and a 38% decline in AIDS-related deaths between 2005 and 2013. Antiretroviral therapy (ART) for the treatment of HIV infection has improved steadily since the advent of potent combination therapy in 1996. ART has dramatically reduced HIV-associated morbidity and mortality. The aim of this study is to see the change in CD4+ count in patient taking various combination of HAART (Highly active anti-retroviral treatment).Methods: A total of 215 patients were included in this study that came to the rims art centre for regular follow up and there cd4+ count at 6 monthly interval upto 18 months was taken and analysed.Results: The patients were evaluated for their change in CD4+ cell count. Mean of CD4+ count at 6 monthly interval was taken in this study which showed that haart combination causes significant improvement in cd4+ count in each group (1) stavudine, lamivudine, nevirapine (2)stavudine, lamivudine, efavirenz (3) zidovudine, lamivudine, nevirapine (4) zidovudine, lamivudine, efavirenz, (5) tenofovir, lamivudine, efavirenz.Conclusions: SLN combination was found most effective in increasing the CD4+ Cell count in comparision to the other combination. Other drugs combinations in decreasing order are as follows- SLE, ZLE, TLE, ZLN.

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Normalisation of CD4 counts in patients with HIV-1 infection and maximum virological suppression who are taking combination antiretroviral therapy: an observational cohort study

Cited by 222 publications

References 37 publications

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria

Sorafenib Therapy for Hepatocellular Carcinoma in an HIV–HCV Coinfected Patient: A Case Report

To study the effect of various combinations of haart in CD4+ cell count in HIV patient at RIMS, Ranchi Art Centre

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Normalisation of CD4 counts in patients with HIV-1 infection and maximum virological suppression who are taking combination antiretroviral therapy: an observational cohort study

Cited by 222 publications

References 37 publications

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4+T-Cell Responses to Mycobacteria

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4+T-Cell Responses to Mycobacteria

Sorafenib Therapy for Hepatocellular Carcinoma in an HIV–HCV Coinfected Patient: A Case Report

To study the effect of various combinations of haart in CD4+ cell count in HIV patient at RIMS, Ranchi Art Centre

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Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria

Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4⁺T-Cell Responses to Mycobacteria