Reference curves for CD4 T‐cell count response to combination antiretroviral therapy in HIV‐1‐infected treatment‐naïve patients. Issue 1 (14th September 2016)

• Record Type: Journal Article
• Authors: Bouteloup, V; Sabin, C; Mocroft, A; Gras, L; Pantazis, N; Le Moing, V; d'Arminio Monforte, A; Mary‐Krause, M; Roca, B; Miro, JM; Battegay, M; Brockmeyer, N; Berenguer, J; Morlat, P; Obel, N; De Wit, S; Fätkenheuer, G; Zangerle, R; Ghosn, J; Pérez‐Hoyos, S; Campbell, M; Prins, M; Chêne, G; Meyer, L; Dorrucci, M; Torti, C; Thiébaut, R
• Other Names: Touloumi Giota investigator.; Warszawski Josiane investigator.; Dabis François investigator.; Leport Catherine investigator.; Wittkop Linda investigator.; Reiss Peter investigator.; Wit Ferdinand investigator.; Bucher Heiner investigator.; Gibb Diana investigator.; Amo Julia Del investigator.; Thorne Claire investigator.; Kirk Ole investigator.; Stephan Christoph investigator.; Hamouda Osamah investigator.; Bartmeyer Barbara investigator.; Chkhartishvili Nikoloz investigator.; Noguera‐Julian Antoni investigator.; Antinori Andrea investigator.; Prieto Luis investigator.; Conejo Pablo Rojo investigator.; Soriano‐Arandes Antoni investigator.; Rauch Andri investigator.; Mussini Cristina investigator.; Tookey Pat investigator.; Casabona Jordi investigator.; Castagna Antonella investigator.; Deborah_Konopnick investigator.; Goetghebuer Tessa investigator.; Sönnerborg Anders investigator.; Teira Ramon investigator.; Garrido Myriam investigator.; Haerry David investigator.; Costagliola Dominique investigator.; Castagna Antonella investigator.; del Amo Julia investigator.; Raben Dorthe investigator.; Judd Ali investigator.; Conejo Pablo Rojo investigator.; Barger Diana investigator.; Colin Céline investigator.; Schwimmer Christine investigator.; Termote Monique investigator.; Wittkop Linda investigator.; Friis‐Møller Nina investigator.; Kjaer Jesper investigator.; Raben Dorthe investigator.; Brandt Rikke Salbøl investigator.; Bohlius Julia investigator.; Bucher Heiner investigator.; Cozzi‐Lepri Alessandro investigator.; Dabis François investigator.; Davies Mary‐Anne investigator.; del Amo Julia investigator.; Dunn David investigator.; Egger Matthias investigator.; Furrer Hansjakob investigator.; Guiguet Marguerite investigator.; Grabar Sophie investigator.; Judd Ali investigator.; Kirk Ole investigator.; Lambotte Olivier investigator.; Leroy Valériane investigator.; Lodi Sara investigator.; Matheron Sophie investigator.; Monge Susana investigator.; Nakagawa Fumiyo investigator.; Paredes Roger investigator.; Phillips Andrew investigator.; Puoti Massimo investigator.; Schomaker Michael investigator.; Smit Colette investigator.; Sterne Jonathan investigator.; Thiebaut Rodolphe investigator.; Thorne Claire investigator.; van der Valk Marc investigator.; Wittkop Linda investigator.; Wyss Natasha investigator.;
• Is Part Of: HIV medicine. Volume 18:Issue 1(2017:Jan.)
• Page Start: 33
• Page End: 44
• Publication Date: 2016-09-14
• Subjects: antiretroviral treatment monitoring -- CD4 response -- HIV monitoring -- longitudinal data; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12389
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: The 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. Methods: All 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. Results: A 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/ μ 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/ μ 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. Conclusions: Reference curves aid the evaluation of the immune response early after antiretroviral therapy initiation that leads to viral control.