Rate and Predictors of Non-AIDS Events in a Cohort of HIV-Infected Patients with a CD4 T Cell Count Above 500 Cells/mm<sup>3</sup>

Lucero, Claudia; Torres, Berta; León, Agathe; Calvo, Marta; Leal, Lorna; Pérez, Iñaki; Plana, Montserrat; Arnedo, Mireia; Mallolas, Josép; Gatell, Josep M.; García, Felipe

doi:10.1089/aid.2012.0367

Cited by 39 publications

(49 citation statements)

References 31 publications

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“…9 Low CD4:CD8 ratio is a risk for clinical progression in virally suppressed indivduals on ART therapy. It is an easy to obtain marker for clinicians to predict the risk of serious non-AIDS defining events and death independently of CD4 restoration.…”

Section: Discussionmentioning

confidence: 99%

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

Alexander¹

2015

HIV/AIDS Res Treat Open J

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Section: Discussionmentioning

confidence: 99%

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

Alexander¹

2015

HIV/AIDS Res Treat Open J

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“…A longer follow-up time may be required to see any differences between the two arms [46■]. In a retrospective Spanish cohort of 675 antiretroviral-naïve patients with CD4 + T cells more than 500 cells/μl, the crude incidence rate of SNAES and SNAE-related mortality was 1.4 per 100 persons-years of follow-up [47]. In those patients whose CD4 + T-cell nadir was more than 350 cells/μl, there was a significant decrease in the crude incidence rate of SNAES and SNAE-related mortality before and after initiation of ART (2.5; 95% confidence interval 1.9–3.2 and 0.6; 95% confidence interval 0.3–1.0 per 100 persons-years of follow-up, respectively).…”

Section: Impact Of Early Art On the Development Of End-organ Damagementioning

confidence: 99%

“…However, in this study, SNAES may have been underreported because only those SNAEs requiring hospital admission were recorded. Furthermore, the study’s analyses were not adjusted for smoking, hypertension, renal function or lipid levels, hence the level of risk of SNAEs in relation to the CD4 + T-cell nadir may have been lower than reported [47]. …”

Section: Impact Of Early Art On the Development Of End-organ Damagementioning

confidence: 99%

Impact of antiretroviral therapy (ART) timing on chronic immune activation/inflammation and end-organ damage

Rajasuriar

Wright

Lewin

2015

Current Opinion in HIV and AIDS

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Purpose of review The purpose of this review was to summarize recent studies on the effect of early antiretroviral therapy (ART) in HIV-infected patients on markers of immune activation/inflammation, viral persistence and serious non-AIDS events. Recent findings Early ART, initiated within days to months of HIV infection, was associated with marked reduction in T-cell activation often reaching levels observed in HIV-uninfected individuals. However, the impact of early ART on markers of innate immune activation, microbial translocation and inflammation/coagulation was less clear. Early ART has also been associated with a significant reduction in the frequency of latently infected cells, which was greater if ART was initiated within days to weeks rather than months following infection. However, few studies have evaluated the relationship between immune activation and viral reservoirs, specifically following early ART. Early ART may potentially reduce serious non-AIDS events and associated mortality, but most of these studies have extrapolated from changes in surrogate markers, such as CD4 : CD8 ratio. Summary Early ART was associated with beneficial effects on multiple markers of immune activation, inflammation and viral persistence. Longer term prospective studies are still needed to determine whether early ART translates to a significant reduction in serious non-AIDS events and mortality.

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“…The attributable risk of CD4 <500cells/μL for CVD events was similar to smoking and greater than lipoprotein concentrations or diabetes. In another study of patients with baseline CD4 count >500cells/μL, nadir CD4 count was an independent predictor of non-AIDS events (of which, 25% were CVD-related)(27). …”

Section: The Role Of Immunodeficiency Hiv Replication Inflammation mentioning

confidence: 99%

Initiation of antiretroviral therapy at high CD4 cell counts

Longenecker¹,

Triant²

2014

Current Opinion in HIV and AIDS

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Purpose of review Inflammation and immune activation associated with untreated HIV infection may increase the risk for cardiovascular disease (CVD) and are not entirely reversed by antiretroviral therapy (ART). While older ART regimens were associated with drug-specific risks for CVD, this may not be true for modern ART. Thus, with regard to CVD risk, the net benefit of initiating antiretroviral therapy at higher CD4+ T-cell counts remains unclear. Recent findings In addition to the well-established risk of coronary heart disease, emerging evidence now suggests that chronic HIV infection is associated with higher risk of ischemic stroke, heart failure, and arrhythmias. These epidemiologic studies have associated immunodeficiency and active viral replication with higher CVD risk. Novel methods of imaging subclinical vascular disease continue to implicate inflammation and immune activation as likely mediators of CVD among patients with HIV. Newer generation protease inhibitors, CCR5 antagonists, and integrase inhibitors do not appear to be associated with the adverse cardiometabolic risks of older drugs. Summary Recent evidence suggests that treating HIV infection with ART may reduce the risk of CVD, even at higher CD4 T-cell counts; however, the definitive answer to this question will come from clinical trials and long-term observational studies.

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Rate and Predictors of Non-AIDS Events in a Cohort of HIV-Infected Patients with a CD4 T Cell Count Above 500 Cells/mm³

Abstract: The reduction of risk of non-AIDS events after combined antiretroviral therapy (cART) initiation and the crude incidence rate (CIR) of these events in patients who control the viral load without cART (controllers) in a cohort of 574 antiretroviral-naive patients with a baseline CD4

Cited by 39 publications

References 31 publications

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

Impact of antiretroviral therapy (ART) timing on chronic immune activation/inflammation and end-organ damage

Initiation of antiretroviral therapy at high CD4 cell counts

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Rate and Predictors of Non-AIDS Events in a Cohort of HIV-Infected Patients with a CD4 T Cell Count Above 500 Cells/mm3

Abstract: The reduction of risk of non-AIDS events after combined antiretroviral therapy (cART) initiation and the crude incidence rate (CIR) of these events in patients who control the viral load without cART (controllers) in a cohort of 574 antiretroviral-naive patients with a baseline CD4

Cited by 39 publications

References 31 publications

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

CD4:CD8 Ratio and Non AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T cell Counts

Impact of antiretroviral therapy (ART) timing on chronic immune activation/inflammation and end-organ damage

Initiation of antiretroviral therapy at high CD4 cell counts

Contact Info

Product

Resources

About

Rate and Predictors of Non-AIDS Events in a Cohort of HIV-Infected Patients with a CD4 T Cell Count Above 500 Cells/mm³