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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings
BMC Infectious Diseases, Volume 12, Article 147, Year 2012
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Description
Background: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART.Method: Naïve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART.Results: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/μL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12.Conclusion: In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART. © 2012 Calmy et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Balestre, Eric
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Bonnet, Fabrice
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
France, Talence
Centre Hospitalier Universitaire de Bordeaux
Boulle, Andrew
South Africa, Cape Town
University of Cape Town
Sprinz, Eduardo
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Wood, Robin Y.
South Africa, Cape Town
Gugulethu Art Programme
Delaporte, Éric
France, Montpellier
Ird Centre de Montpellier
Messou, Eugéne
Cote D'ivoire, Abidjan
Centre de Prise en Charge de Recherche et de Formation Cepref
McIntyre, James Alasdair
South Africa
Operational Research on Art Opera
Marhoum El Filali, Kamal
Morocco, Casablanca
Centre Hospitalier Universitaire Ibn Rochd
Schechter, Mauro T.
Brazil, Rio de Janeiro
Rio Hiv Cohort
Kumarasamy, Nagalingeswaran
India, Chennai
Yr Gaitonde Centre for Aids Research and Education
Bangsberg, David R.
Uganda, Mbarara
Immune Suppression Syndrome Clinic Iss
McPhail, Patrick
South Africa, Johannesburg
Helen Joseph Hospital
van der Borght, Stefaan F.M.
Netherlands, Amsterdam
Heineken International
Zala, Carlos A.
Argentina, Buenos Aires
Prospective Evaluation in the use and Monitoring of Antiretrovirals in Argentina Puma
Egger, Matthias
Switzerland, Bern
University of Bern
Thíébaut, Rodolphe
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Dabis, Franćois Ç.Ois
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Statistics
Citations: 19
Authors: 19
Affiliations: 18
Identifiers
Doi:
10.1186/1471-2334-12-147
e-ISSN:
14712334
Research Areas
Infectious Diseases
Study Design
Cohort Study
Participants Gender
Female