Journal
HIV MEDICINE
Volume 18, Issue 1, Pages 33-44Publisher
WILEY-BLACKWELL
DOI: 10.1111/hiv.12389
Keywords
antiretroviral treatment monitoring; CD4 response; HIV monitoring; longitudinal data
Categories
Funding
- Abbvie
- Bristol-Myers Squibb
- Gilead Sciences
- Merck
- Novartis y Sanofi
- Cubist
- Gilead
- ViiV
- Novartis
- Fondo de Investigaciones Sanitarias (FIS) del Instituto de Salud Carlos III (Madrid)
- Fundacion para la Investigacion y Prevencion del Sida en Espana (FIPSE
- Madrid)
- Ministerio de Sanidad, Servicios Sociales e Igualdad (MSSSI
- Madrid)
- National Institutes of Health (NIH
- Bethesda, MA, USA)
- NEAT
- ViiV Healthcare
- Instituto de Salud Carlos III, Ministerio de Economia y Competitividad, Madrid (Spain) [INT15/00168]
- Agence Nationale de Recherches sur le SIDA et les Hepatites Virales (ANRS), France
- HIV Monitoring Foundation
- Netherlands
- Augustinus Foundation, Denmark
- European Union [260694]
- MRC [MC_UU_12023/15, MR/M004236/1] Funding Source: UKRI
- Medical Research Council [MC_UU_12023/15, MR/M004236/1] Funding Source: researchfish
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ObjectivesThe aim of this work was to provide a reference for the CD4 T-cell count response in the early months after the initiation of combination antiretroviral therapy (cART) in HIV-1-infected patients. MethodsAll patients in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) cohort who were aged 18 years and started cART for the first time between 1 January 2005 and 1 January 2010 and who had at least one available measurement of CD4 count and a viral load 50 HIV-1 RNA copies/mL at 6 months ( 3 months) after cART initiation were included in the study. Unadjusted and adjusted references curves and predictions were obtained using quantile regressions. ResultsA total of 28 992 patients were included in the study. The median CD4 T-cell count at treatment initiation was 249 [interquartile range (IQR) 150, 336] cells/L. The median observed CD4 counts at 6, 9 and 12 months were 382 (IQR 256, 515), 402 (IQR 274, 543) and 420 (IQR 293, 565) cells/L. The two main factors explaining the variation of CD4 count at 6 months were AIDS stage and CD4 count at cART initiation. A CD4 count increase of 100 cells/mL is generally required in order that patients stay on track' (i.e. with a CD4 count at the same percentile as when they started), with slightly higher gains required for those starting with CD4 counts in the higher percentiles. Individual predictions adjusted for factors influencing CD4 count were more precise. ConclusionsReference curves aid the evaluation of the immune response early after antiretroviral therapy initiation that leads to viral control.
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