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Effect of nucleoside reverse transcriptase inhibitors on CD4 T‐cell recovery in HIV‐1‐infected individuals receiving long‐term fully suppressive combination antiretroviral therapy
Author(s) -
Byakwaga H,
Zhou J,
Petoumenos K,
Law MG,
Boyd MA,
Emery S,
Cooper DA,
Mallon PW
Publication year - 2009
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/j.1468-1293.2008.00663.x
Subject(s) - didanosine , stavudine , medicine , cart , interquartile range , zidovudine , reverse transcriptase inhibitor , nucleoside reverse transcriptase inhibitor , antiretroviral therapy , lamivudine , zalcitabine , gastroenterology , viral load , cohort , retrospective cohort study , immunology , human immunodeficiency virus (hiv) , virus , viral disease , mechanical engineering , hepatitis b virus , engineering
Objective The aim of the study was to determine the effect of nucleoside reverse transcriptase inhibitors (NRTIs) on CD4 recovery in HIV‐1‐infected individuals receiving long‐term suppressive combination antiretroviral therapy (cART). Methods A retrospective cohort study was carried out. The mean time‐weighted CD4 change from baseline was determined at weeks 48, 96 and 144: its associations with exposure to NRTIs were assessed using linear regression. Results One hundred and five patients were included. Their median baseline CD4 count was 225 (interquartile range 91–362) cells/μL. A trend of greater CD4 change from baseline was observed for individuals who at baseline had CD4 counts >200 cells/μL (138 vs . 113, 176 vs . 134 and 204 vs . 173 cells/μL), or were ≤40 years old (136 vs . 118, 182 vs . 150, 208 vs . 174) at weeks 48, 96 and 144, respectively; however, all P ‐values were >0.05. Lower CD4 increases were observed in patients exposed to didanosine (ddI) or a combination of ddI and stavudine, although the difference was not statistically significant. For patients that commenced cART with CD4 count ≤200 cells/μL, a trend towards a CD4 count response <250 cells/μL at weeks 48, 96 and 144 was observed in patients receiving zidovudine. Conclusion Exposure to different NRTIs in initial cART was not significantly associated with variable rises in CD4 cell count. However, these findings need to be confirmed in larger studies.