Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings

 

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dc.contributor.author Calmy, Alexandra en_ZA
dc.contributor.author Balestre, Eric en_ZA
dc.contributor.author Bonnet, Fabrice en_ZA
dc.contributor.author Boulle, Andrew en_ZA
dc.contributor.author Sprinz, Eduardo en_ZA
dc.contributor.author Wood, Robin en_ZA
dc.contributor.author Delaporte, Eric en_ZA
dc.contributor.author Messou, Eugene en_ZA
dc.contributor.author McIntyre, James en_ZA
dc.contributor.author El Filali, Kamal en_ZA
dc.contributor.author Schechter, Mauro en_ZA
dc.contributor.author Kumarasamy, N en_ZA
dc.contributor.author Bangsberg, David en_ZA
dc.contributor.author McPhail, Patrick en_ZA
dc.contributor.author Van Der Borght, en_ZA
dc.date.accessioned 2015-11-18T04:02:57Z
dc.date.available 2015-11-18T04:02:57Z
dc.date.issued 2012 en_ZA
dc.identifier.citation Calmy, A., Balestre, E., Bonnet, F., Boulle, A., Sprinz, E., Wood, R., ... & Dabis, F. (2012). Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings. BMC infectious diseases, 12(1), 147. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15105
dc.identifier.uri http://dx.doi.org/10.1186/1471-2334-12-147
dc.description.abstract 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:Naive 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 12months 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 1.6years, a median age of 34years, and a median CD4 cell count at ART initiation of 107 cells/muL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18months 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. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Infectious Diseases en_ZA
dc.source.uri http://www.biomedcentral.com/bmcinfectdis/ en_ZA
dc.subject.other CD4 cell counts en_ZA
dc.subject.other low or moderate-level viremia en_ZA
dc.subject.other Antiretroviral treatment (ART) en_ZA
dc.title Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2012 Calmy et al.; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License