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Reference curves for CD 4 T‐cell count response to combination antiretroviral therapy in HIV ‐1‐infected treatment‐naïve patients
Author(s) -
Bouteloup V,
Sabin C,
Mocroft A,
Gras L,
Pantazis N,
Le Moing V,
d'Arminio Monforte A,
MaryKrause M,
Roca B,
Miro JM,
Battegay M,
Brockmeyer N,
Berenguer J,
Morlat P,
Obel N,
De Wit S,
Fätkenheuer G,
Zangerle R,
Ghosn J,
PérezHoyos S,
Campbell M,
Prins M,
Chêne G,
Meyer L,
Dorrucci M,
Torti C,
Thiébaut R
Publication year - 2017
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12389
Subject(s) - interquartile range , medicine , cart , percentile , viral load , cohort , antiretroviral therapy , immunology , human immunodeficiency virus (hiv) , gastroenterology , mechanical engineering , statistics , mathematics , engineering
Objectives The aim of this work was to provide a reference for the CD 4 T‐cell count response in the early months after the initiation of combination antiretroviral therapy ( cART ) in HIV ‐1‐infected patients. Methods All patients in the Collaboration of Observational HIV Epidemiological Research Europe ( COHERE ) cohort who were aged ≥ 18 years and started cART for the first time between 1 January 2005 and 1 January 2010 and who had at least one available measurement of CD 4 count and a viral load ≤ 50 HIV ‐1 RNA copies/ mL at 6 months (± 3 months) after cART initiation were included in the study. Unadjusted and adjusted references curves and predictions were obtained using quantile regressions. Results A total of 28 992 patients were included in the study. The median CD 4 T‐cell count at treatment initiation was 249 [interquartile range ( IQR ) 150, 336] cells/ μ L. The median observed CD 4 counts at 6, 9 and 12 months were 382 ( IQR 256, 515), 402 ( IQR 274, 543) and 420 ( IQR 293, 565) cells/ μ L. The two main factors explaining the variation of CD 4 count at 6 months were AIDS stage and CD 4 count at cART initiation. A CD 4 count increase of ≥ 100 cells/ mL is generally required in order that patients stay ‘on track’ (i.e. with a CD 4 count at the same percentile as when they started), with slightly higher gains required for those starting with CD 4 counts in the higher percentiles. Individual predictions adjusted for factors influencing CD4 count were more precise. Conclusions Reference curves aid the evaluation of the immune response early after antiretroviral therapy initiation that leads to viral control.