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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predictors of CD4 cell recovery following initiation of antiretroviral therapy among HIV-1 positive patients with well-estimated dates of seroconversion
HIV Medicine, Volume 19, No. 3, Year 2018
Notification
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Description
Objectives: To investigate factors that predict speed of recovery and long-term CD4 cell count in HIV-1 seroconverters initiating combination antiretroviral therapy (cART), and to quantify the influence of very early treatment initiation. We make use of all pre-treatment CD4 counts, because analyses using only a single observation at initiation may be subject to biases. Methods: We used data from the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) multinational cohort collaboration of HIV-1 seroconverters. We analysed pre- and post-treatment data of patients with seroconversion dates estimated January 2003–March 2014 (n = 7600 for primary analysis) using a statistical model in which the characteristics of recovery in CD4 counts are determined by multiple predictive factors. Secondary analyses were performed incorporating uncertainty in the exact timing of seroconversion to allow more precise estimation of the benefit of very early treatment initiation. Results: ‘True’ CD4 count at cART initiation was the strongest predictor of CD4 count beyond 3 years on cART. Allowing for lack of complete certainty in the date of seroconversion, CD4 recovery was more rapid for patients in whom treatment was initiated within 4 months. For a given CD4 count, higher viral load (VL) at initiation was strongly associated with higher post-treatment CD4 recovery. For other patient and drug characteristics, associations with recovery were statistically significant but small in magnitude. Conclusions: CD4 count at cART initiation is the most important factor in predicting post-treatment recovery, but VL provides substantial additional information. If cART is initiated in the first 4 months following seroconversion, recovery of CD4 counts appears to be more rapid. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC5836945/bin/HIV-19-184-s001.pdf
Authors & Co-Authors
Stirrup, Oliver T.
United Kingdom, London
Mrc Clinical Trials Unit
Copas, Andrew J.
United Kingdom, London
Mrc Clinical Trials Unit
Phillips, Andrew N.
United Kingdom, London
University College London
Gill, M. John
Canada, Calgary
University of Calgary
Geskus, Ronald Bertus
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Netherlands, Utrecht
Netherlands Public Health Service
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
United Kingdom, Oxford
University of Oxford
Touloumi, Giota
Greece, Athens
National and Kapodistrian University of Athens
Bucher, Heíner C.C.
Switzerland, Basel
Universitätsspital Basel
Babiker, Abdel G.A.G.
United Kingdom, London
Mrc Clinical Trials Unit
Kelleher, Anthony D.
Unknown Affiliation
Cooper, David A.
Unknown Affiliation
Grey, Pat A.
Unknown Affiliation
Finlayson, Robert James
Unknown Affiliation
Bloch, Mark Theo
Unknown Affiliation
Ramacciotti, Tim
Unknown Affiliation
Gelgor, Linda
Unknown Affiliation
Smith, Don E.
Unknown Affiliation
Zangerle, Robert
Unknown Affiliation
Lutsar, Irja
Unknown Affiliation
Chêne, Geneviève
Unknown Affiliation
Dabis, François
Unknown Affiliation
Thíébaut, Rodolphe
Unknown Affiliation
Costagliola, Dominique G.
Unknown Affiliation
Guiguet, Marguerite
Unknown Affiliation
Vanhems, Philippe V.
Unknown Affiliation
Chaix, Marie Laure
Unknown Affiliation
Ghosn, Jade
Unknown Affiliation
Meyer, Laurence J.
Unknown Affiliation
Boufassa, Faroudy
Unknown Affiliation
Hamouda, Osamah
Unknown Affiliation
Meixenberger, Karolin
Unknown Affiliation
Bannert, Norbert
Unknown Affiliation
Gunsenheimer-Bartmeyer, Barbara
Unknown Affiliation
Antoniadou, Anastasia C.
Unknown Affiliation
Chrysos, Georgios
Unknown Affiliation
Daikos, Georgios L.
Unknown Affiliation
Pantazis, Nikos
Unknown Affiliation
Katsarou, Olga I.
Unknown Affiliation
Rezza, Giovanni
Unknown Affiliation
Dorrucci, Maria
Unknown Affiliation
Monforte, Antonella D’Arminio
Unknown Affiliation
Prins, Maria
Unknown Affiliation
Geskus, Ronald B.
Unknown Affiliation
Schuitemaker, Hanneke
Unknown Affiliation
Sannes, Mette
Unknown Affiliation
Brubakk, Oddbjørn
Unknown Affiliation
Kran, Anne Marte Bakken
Unknown Affiliation
Rosinska, Magdalena
Unknown Affiliation
Muga, Roberto
Unknown Affiliation
Tor, Jordi
Unknown Affiliation
Moreno, Santiago C.
Unknown Affiliation
Monge, Susana
Unknown Affiliation
Pérez-Hoyos, Santiago
Unknown Affiliation
Sonnerb̈org, Anders
Unknown Affiliation
Günthard, Hüldrych Fritz
Unknown Affiliation
Scherrer, Alexandra U.
Unknown Affiliation
Malyuta, Ruslan
Unknown Affiliation
Murphy, Gary R.
Unknown Affiliation
Porter, Kholoud
Unknown Affiliation
Johnson, Anne M.
Unknown Affiliation
Babiker, Abdel G.
Unknown Affiliation
Morris, Lynn G.
Unknown Affiliation
Morrison, Charles S.
Unknown Affiliation
Salata, Robert A.
Unknown Affiliation
Mugerwa, Roy D.
Unknown Affiliation
Chipato, Tsungai
Unknown Affiliation
Price, Matt A.
Unknown Affiliation
Gilmour, Jill W.
Unknown Affiliation
Kamali, Anatoli
Unknown Affiliation
Karita, Etienne
Unknown Affiliation
Statistics
Citations: 39
Authors: 69
Affiliations: 9
Identifiers
Doi:
10.1111/hiv.12567
ISSN:
14642662
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study