Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption
OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known. METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/μL. Cox proportional hazards models were used to identify p...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2009-12, Vol.52 (5), p.588-594 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
| container_volume | 52 |
| creator | Mussini, Cristina Touloumi, Giota Bakoyannis, Giorgos Sabin, Caroline Castagna, Antonella Sighinolfi, Laura Erikson, Lars E Bratt, Goran Borghi, Vanni Lazzarin, Adriano Cossarizza, Andrea Esposito, Roberto |
| description | OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.
METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/μL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.
RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/μL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/μL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads |
| doi_str_mv | 10.1097/QAI.0b013e3181b9e94d |
| format | Article |
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METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/μL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.
RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/μL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/μL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads <5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.
CONCLUSIONS:Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e3181b9e94d</identifier><identifier>PMID: 19950432</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; AIDS/HIV ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; CD4 Lymphocyte Count ; Drug therapy ; Female ; HIV Infections - drug therapy ; HIV Infections - immunology ; Human viral diseases ; Humans ; Immunology ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Patients ; Retrospective Studies ; Treatment Refusal ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Virology</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2009-12, Vol.52 (5), p.588-594</ispartof><rights>2009 Lippincott Williams & Wilkins, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Dec 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528d-d732ac9b39013aafd2fa6a45d1c6915bfe398158a305ddc46fa47800dd7711d93</citedby><cites>FETCH-LOGICAL-c528d-d732ac9b39013aafd2fa6a45d1c6915bfe398158a305ddc46fa47800dd7711d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22176595$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19950432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:119674699$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Mussini, Cristina</creatorcontrib><creatorcontrib>Touloumi, Giota</creatorcontrib><creatorcontrib>Bakoyannis, Giorgos</creatorcontrib><creatorcontrib>Sabin, Caroline</creatorcontrib><creatorcontrib>Castagna, Antonella</creatorcontrib><creatorcontrib>Sighinolfi, Laura</creatorcontrib><creatorcontrib>Erikson, Lars E</creatorcontrib><creatorcontrib>Bratt, Goran</creatorcontrib><creatorcontrib>Borghi, Vanni</creatorcontrib><creatorcontrib>Lazzarin, Adriano</creatorcontrib><creatorcontrib>Cossarizza, Andrea</creatorcontrib><creatorcontrib>Esposito, Roberto</creatorcontrib><title>Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.
METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/μL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.
RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/μL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/μL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads <5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.
CONCLUSIONS:Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Drug therapy</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Treatment Refusal</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Virology</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFv1DAQhSMEoqXwDxCKkFBPKZ7Yju1jtKV0pSJEtZwtx57QtImz2Amr_fd42ahIPcBpRjPfG83Ty7K3QC6AKPHxW72-IA0BihQkNAoVc8-yU1CMFUJK9jz1vOQFA8pPslcx3hMCFWPqZXYCSnHCaHmadV_MD99Ns8PceJdf4oRh6LzxU8zHNl9dsvwW7fgLwz6v27TMr-v6dpOGcR62Uzf6ZQz5am97PIg2Ac00oJ_ytU-rMP_hXmcvWtNHfLPUs-z71afN6rq4-fp5vapvCstL6QonaGmsaqhK1oxpXdmayjDuwFYKeNMiVRK4NJRw5yyrWsOEJMQ5IQCcomdZcbwbd7idG70N3WDCXo-m08voIXWoOWeMl4k_P_LbMP6cMU566KLFvjcexzlqwSoiheT8_yRlUIFkIpHvn5D34xx8sq1LSisOFEiC2BGyYYwxYPv4KhB9iFiniPXTiJPs3XJ7bgZ0f0VLpgn4sAAmWtO3wXjbxUeuLEFUXB3syCO3G_sUU3zo5x0GfYemn-7-_cNvVw3BWQ</recordid><startdate>200912</startdate><enddate>200912</enddate><creator>Mussini, Cristina</creator><creator>Touloumi, Giota</creator><creator>Bakoyannis, Giorgos</creator><creator>Sabin, Caroline</creator><creator>Castagna, Antonella</creator><creator>Sighinolfi, Laura</creator><creator>Erikson, Lars E</creator><creator>Bratt, Goran</creator><creator>Borghi, Vanni</creator><creator>Lazzarin, Adriano</creator><creator>Cossarizza, Andrea</creator><creator>Esposito, Roberto</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>200912</creationdate><title>Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption</title><author>Mussini, Cristina ; Touloumi, Giota ; Bakoyannis, Giorgos ; Sabin, Caroline ; Castagna, Antonella ; Sighinolfi, Laura ; Erikson, Lars E ; Bratt, Goran ; Borghi, Vanni ; Lazzarin, Adriano ; Cossarizza, Andrea ; Esposito, Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528d-d732ac9b39013aafd2fa6a45d1c6915bfe398158a305ddc46fa47800dd7711d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Drug therapy</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunology</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Treatment Refusal</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mussini, Cristina</creatorcontrib><creatorcontrib>Touloumi, Giota</creatorcontrib><creatorcontrib>Bakoyannis, Giorgos</creatorcontrib><creatorcontrib>Sabin, Caroline</creatorcontrib><creatorcontrib>Castagna, Antonella</creatorcontrib><creatorcontrib>Sighinolfi, Laura</creatorcontrib><creatorcontrib>Erikson, Lars E</creatorcontrib><creatorcontrib>Bratt, Goran</creatorcontrib><creatorcontrib>Borghi, Vanni</creatorcontrib><creatorcontrib>Lazzarin, Adriano</creatorcontrib><creatorcontrib>Cossarizza, Andrea</creatorcontrib><creatorcontrib>Esposito, Roberto</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mussini, Cristina</au><au>Touloumi, Giota</au><au>Bakoyannis, Giorgos</au><au>Sabin, Caroline</au><au>Castagna, Antonella</au><au>Sighinolfi, Laura</au><au>Erikson, Lars E</au><au>Bratt, Goran</au><au>Borghi, Vanni</au><au>Lazzarin, Adriano</au><au>Cossarizza, Andrea</au><au>Esposito, Roberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2009-12</date><risdate>2009</risdate><volume>52</volume><issue>5</issue><spage>588</spage><epage>594</epage><pages>588-594</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.
METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/μL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.
RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/μL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/μL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads <5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.
CONCLUSIONS:Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>19950432</pmid><doi>10.1097/QAI.0b013e3181b9e94d</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete; Free E- Journals |
| subjects | Adult AIDS/HIV Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences CD4 Lymphocyte Count Drug therapy Female HIV Infections - drug therapy HIV Infections - immunology Human viral diseases Humans Immunology Infectious diseases Male Medical sciences Middle Aged Patients Retrospective Studies Treatment Refusal Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology |
| title | Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption |
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