Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Long-term immunologic response to antiretroviral therapy in low-income countries: A collaborative analysis of prospective studies
AIDS, Volume 22, No. 17, Year 2008
Notification
URL copied to clipboard!
Description
Background: Few data are available on the long-term immunologic response to antiretroviral therapy (ART) in resource-limited settings, where ART is being rapidly scaled up using a public health approach, with a limited repertoire of drugs. Objectives: To describe immunologic response to ART among ART patients in a network of cohorts from sub-Saharan Africa, Latin America, and Asia. Study population/methods: Treatment-naive patients aged 15 and older from 27 treatment programs were eligible. Multilevel, linear mixed models were used to assess associations between predictor variables and CD4 cell count trajectories following ART initiation. Results: Of 29 175 patients initiating ART, 8933 (31%) were excluded due to insufficient follow-up time and early lost to follow-up or death. The remaining 19 967 patients contributed 39 200 person-years on ART and 71 067 CD4 cell count measurements. The median baseline CD4 cell count was 114 cells/μl, with 35% having less than 100 cells/μl. Substantial intersite variation in baseline CD4 cell count was observed (range 61-181 cells/μl). Women had higher median baseline CD4 cell counts than men (121 vs. 104 cells/μl). The median CD4 cell count increased from 114 cells/μl at ART initiation to 230 [interquartile range (IQR) 144-338] at 6 months, 263 (IQR 175-376) at 1 year, 336 (IQR 224-472) at 2 years, 372 (IQR 242-537) at 3 years, 377 (IQR 221-561) at 4 years, and 395 (IQR 240-592) at 5 years. In multivariable models, baseline CD4 cell count was the most important determinant of subsequent CD4 cell count trajectories. Conclusion: These data demonstrate robust and sustained CD4 response to ART among patients remaining on therapy. Public health and programmatic interventions leading to earlier HIV diagnosis and initiation of ART could substantially improve patient outcomes in resource-limited settings. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Nash, Denis B.
United States, New York
Columbia University
Katyal, Monica
Unknown Affiliation
Brinkhof, Martin W.G.
Unknown Affiliation
Keiser, Olivia
Unknown Affiliation
May, Margaret T.
Unknown Affiliation
Hughes, Rachael A.
Unknown Affiliation
Dabis, Franćois Ç.Ois
Unknown Affiliation
Wood, Robin Y.
Unknown Affiliation
Sprinz, Eduardo
Unknown Affiliation
Schechter, Mauro T.
Unknown Affiliation
Egger, Matthias
Unknown Affiliation
Statistics
Citations: 193
Authors: 11
Affiliations: 1
Identifiers
Doi:
10.1097/QAD.0b013e3283121ca9
ISSN:
02699370
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Male
Female