Journal Article

Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4<sup>+</sup> Cell Counts after Successful Virologic Suppression

Fernando Dronda, Santiago Moreno, Ana Moreno, L. Casado José, María J. Pérez-Elías and Antonio Antela

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 8, pages 1005-1009
Published in print October 2002 | ISSN: 1058-4838
Published online October 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/342695
Long-Term Outcomes among Antiretroviral-Naive Human Immunodeficiency Virus–Infected Patients with Small Increases in CD4+ Cell Counts after Successful Virologic Suppression

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To evaluate the frequency and predictive factors of discordant immune response, we performed a prospective cohort study of 288 antiretroviral-naive human immunodeficiency virus (HIV)–infected patients who initiated highly active antiretroviral therapy (HAART) and maintained complete virus suppression for ⩾24 months. The median CD4+ cell count was 186 × 106 cells/L, and the median HIV RNA level was 5 log10 copies/mL. After 24 months of therapy, 42 (16.5%) of 255 patients had a median CD4+ cell count increase of < 100 × 106 cells/L. By logistic regression analysis, previous injection drug use was associated with a CD4+ cell count increase of < 100 × 106 cells/L (risk ratio [RR], 2.326; 95% confidence interval [CI], 1.077–5.023; P = .032); inclusion of a protease inhibitor (PI) in the HAART regimen reduced the risk of poor immunologic recovery (RR, 0.160; 95% CI, 0.061–0.417; P < .001). Failure of the CD4+ cell count to increase was relatively common among antiretroviral-naive patients in the year after the initiation of HAART and the achievement of complete virus suppression. PI-containing regimens provided better immunologic response.

Journal Article.  3632 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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