Document Detail

Long-term evolution of CD4 count in patients with a plasma HIV RNA persistently <500 copies/mL during treatment with antiretroviral drugs.
MedLine Citation:
PMID:  17461859     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The increase in CD4 count may reach a plateau after some duration of virological response to highly active antiretroviral therapy (HAART). METHODS: A total of 1281 HIV-infected patients initiating HAART were enrolled in the AntiPROtease (APROCO) cohort. We investigated determinants of increase in CD4 count using longitudinal mixed models in patients who maintained a plasma HIV RNA <500 HIV-1 RNA copies/mL. RESULTS: A total of 870 patients had a virological response at month 4. The median follow-up time was 57 months. Mean estimated increases in CD4 count in patients with persistent virological response were 29.9 cells/muL/month before month 4, 6.4 cells/microL/month between months 4 and 36, and 0.7 cells/microL/month (not significantly different from 0) after month 36. Three factors were associated with a significantly positive CD4 count slope after month 36: male gender (+0.9), no history of antiretroviral therapy at baseline (+1.7) and baseline CD4 count <100 cells/microL (+2.6). In patients who maintained a virological response after 5 years of HAART, a CD4 count >500 cells/microL was achieved in 83% of those with a baseline CD4 count >or=200 cells/microL and in 45% of those with a baseline CD4 count <200 cells/microL. CONCLUSION: The increase in CD4 count reaches a plateau after 3 years of virological response. Even if patients initiating HAART with low CD4 counts still show a CD4 count increase after 3 years, it remains insufficient to overcome immune deficiency in all patients.
V Le Moing; R Thiébaut; G Chêne; A Sobel; P Massip; F Collin; Mc Meyohas; F Al Kaïed; C Leport; F Raffi;
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  HIV medicine     Volume:  8     ISSN:  1464-2662     ISO Abbreviation:  HIV Med.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-27     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897392     Medline TA:  HIV Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  156-63     Citation Subset:  IM    
Service des Maladies Infectieuses et Tropicales, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire, Montpellier, France.
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MeSH Terms
Antiretroviral Therapy, Highly Active / methods*
CD4 Lymphocyte Count
Cohort Studies
HIV Infections / drug therapy*,  immunology*,  virology
HIV-1 / genetics,  growth & development*,  immunology
Linear Models
Longitudinal Studies
Middle Aged
Multivariate Analysis
Prospective Studies
RNA, Viral / blood*
Reg. No./Substance:
0/RNA, Viral

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