Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4+ Cell Counts after Successful Virologic Suppression
To evaluate the frequency and predictive factors of discordant immune response, we performed a prospective cohort study of 288 antiretroviral-naive human immunodeficiency virus (HIV)–infected patients who initiated highly active antiretroviral therapy (HAART) and maintained complete virus suppressio...
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| Veröffentlicht in: | Clinical infectious diseases 2002-10, Vol.35 (8), p.1005-1009 |
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| container_title | Clinical infectious diseases |
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| creator | Dronda, Fernando Moreno, Santiago Moreno, Ana José, L. Casado Pérez-Elías, María J. Antela, Antonio |
| description | To evaluate the frequency and predictive factors of discordant immune response, we performed a prospective cohort study of 288 antiretroviral-naive human immunodeficiency virus (HIV)–infected patients who initiated highly active antiretroviral therapy (HAART) and maintained complete virus suppression for ⩾24 months. The median CD4+ cell count was 186 × 106 cells/L, and the median HIV RNA level was 5 log10 copies/mL. After 24 months of therapy, 42 (16.5%) of 255 patients had a median CD4+ cell count increase of < 100 × 106 cells/L. By logistic regression analysis, previous injection drug use was associated with a CD4+ cell count increase of < 100 × 106 cells/L (risk ratio [RR], 2.326; 95% confidence interval [CI], 1.077–5.023; P = .032); inclusion of a protease inhibitor (PI) in the HAART regimen reduced the risk of poor immunologic recovery (RR, 0.160; 95% CI, 0.061–0.417; P < .001). Failure of the CD4+ cell count to increase was relatively common among antiretroviral-naive patients in the year after the initiation of HAART and the achievement of complete virus suppression. PI-containing regimens provided better immunologic response. |
| doi_str_mv | 10.1086/342695 |
| format | Article |
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By logistic regression analysis, previous injection drug use was associated with a CD4+ cell count increase of < 100 × 106 cells/L (risk ratio [RR], 2.326; 95% confidence interval [CI], 1.077–5.023; P = .032); inclusion of a protease inhibitor (PI) in the HAART regimen reduced the risk of poor immunologic recovery (RR, 0.160; 95% CI, 0.061–0.417; P < .001). Failure of the CD4+ cell count to increase was relatively common among antiretroviral-naive patients in the year after the initiation of HAART and the achievement of complete virus suppression. PI-containing regimens provided better immunologic response.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/342695</identifier><identifier>PMID: 12355389</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Adult ; Aged ; AIDS ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; CD4 Lymphocyte Count ; Cellular immunity ; Female ; Highly active antiretroviral therapy ; HIV ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV-1 - drug effects ; HIV/AIDS ; Human viral diseases ; Humans ; Immune response ; Immunity - drug effects ; Immunology ; Infectious diseases ; Injections ; Male ; Medical sciences ; Middle Aged ; Outcome Assessment (Health Care) ; Pharmacology. 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Casado</creatorcontrib><creatorcontrib>Pérez-Elías, María J.</creatorcontrib><creatorcontrib>Antela, Antonio</creatorcontrib><title>Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4+ Cell Counts after Successful Virologic Suppression</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>To evaluate the frequency and predictive factors of discordant immune response, we performed a prospective cohort study of 288 antiretroviral-naive human immunodeficiency virus (HIV)–infected patients who initiated highly active antiretroviral therapy (HAART) and maintained complete virus suppression for ⩾24 months. The median CD4+ cell count was 186 × 106 cells/L, and the median HIV RNA level was 5 log10 copies/mL. After 24 months of therapy, 42 (16.5%) of 255 patients had a median CD4+ cell count increase of < 100 × 106 cells/L. By logistic regression analysis, previous injection drug use was associated with a CD4+ cell count increase of < 100 × 106 cells/L (risk ratio [RR], 2.326; 95% confidence interval [CI], 1.077–5.023; P = .032); inclusion of a protease inhibitor (PI) in the HAART regimen reduced the risk of poor immunologic recovery (RR, 0.160; 95% CI, 0.061–0.417; P < .001). Failure of the CD4+ cell count to increase was relatively common among antiretroviral-naive patients in the year after the initiation of HAART and the achievement of complete virus suppression. PI-containing regimens provided better immunologic response.</description><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Cellular immunity</subject><subject>Female</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV-1 - drug effects</subject><subject>HIV/AIDS</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immune response</subject><subject>Immunity - drug effects</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Injections</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>T lymphocytes</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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Aids</topic><topic>Virology</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dronda, Fernando</creatorcontrib><creatorcontrib>Moreno, Santiago</creatorcontrib><creatorcontrib>Moreno, Ana</creatorcontrib><creatorcontrib>José, L. 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Casado</au><au>Pérez-Elías, María J.</au><au>Antela, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4+ Cell Counts after Successful Virologic Suppression</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2002-10-15</date><risdate>2002</risdate><volume>35</volume><issue>8</issue><spage>1005</spage><epage>1009</epage><pages>1005-1009</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>To evaluate the frequency and predictive factors of discordant immune response, we performed a prospective cohort study of 288 antiretroviral-naive human immunodeficiency virus (HIV)–infected patients who initiated highly active antiretroviral therapy (HAART) and maintained complete virus suppression for ⩾24 months. The median CD4+ cell count was 186 × 106 cells/L, and the median HIV RNA level was 5 log10 copies/mL. After 24 months of therapy, 42 (16.5%) of 255 patients had a median CD4+ cell count increase of < 100 × 106 cells/L. By logistic regression analysis, previous injection drug use was associated with a CD4+ cell count increase of < 100 × 106 cells/L (risk ratio [RR], 2.326; 95% confidence interval [CI], 1.077–5.023; P = .032); inclusion of a protease inhibitor (PI) in the HAART regimen reduced the risk of poor immunologic recovery (RR, 0.160; 95% CI, 0.061–0.417; P < .001). Failure of the CD4+ cell count to increase was relatively common among antiretroviral-naive patients in the year after the initiation of HAART and the achievement of complete virus suppression. PI-containing regimens provided better immunologic response.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>12355389</pmid><doi>10.1086/342695</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical infectious diseases, 2002-10, Vol.35 (8), p.1005-1009 |
| issn | 1058-4838 1537-6591 |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged AIDS Anti-HIV Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral Therapy, Highly Active Antiviral agents Biological and medical sciences CD4 Lymphocyte Count Cellular immunity Female Highly active antiretroviral therapy HIV HIV Infections - drug therapy HIV Infections - immunology HIV-1 - drug effects HIV/AIDS Human viral diseases Humans Immune response Immunity - drug effects Immunology Infectious diseases Injections Male Medical sciences Middle Aged Outcome Assessment (Health Care) Pharmacology. Drug treatments Risk Factors T lymphocytes Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology Viruses |
| title | Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4+ Cell Counts after Successful Virologic Suppression |
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