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Prolonged decrease of CD4+ T lymphocytes in HIV-1 infected patients after radiotherapy for a solid tumor.
MedLine Citation:
PMID:  23314415     Owner:  NLM     Status:  Publisher    
BACKGROUND:: In HIV-negative patients radiotherapy (RT) decreases CD4T-cell counts. We studied the effects of RT in HIV-1 positive patients. METHODS:: HIV-1 positive patients with a subsequent diagnosis of a solid tumor were selected from the Dutch national observational HIV cohort (ATHENA). Patients were grouped according to whether they had received RT or not. Primary endpoint of the study was time from baseline to reaching CD4 cell counts higher than those at baseline. Kaplan-Meier estimates of the percentage of patients reaching the endpoint were calculated. RESULTS:: 90 patients were included of which 36 received RT and 54 not. Median duration of RT was 46 (IQR 30-63) days. Median first CD4 cell count after stopping RT was 150 (IQR 30-270) x10/L lower compared with baseline. In 13 of the 36 patients receiving RT, CD4 cell counts recovered to baseline, after a median of 469 (IQR 345-595) days. In 35 of the 54 patients without RT CD4 cell count recovered to baseline or higher, after a median of 112 (IQR 42-182) days. After 3 years, in 39% of patients who had RT compared to 71% of patients without RT CD4 cell counts recovered to baseline or higher (p<0.0001). In a Cox regression adjusted for potential confounders, RT was associated with a longer (HR 0.29 (95% CI 0.13 - 0.63), and cART use with a shorter time to return to baseline (HR 2.46 (95% CI 1.11-5.48). CONCLUSION:: RT resulted in a significant and prolonged decrease in CD4 cell counts.
Sanjay U C Sankatsing; Mariska M J Hillebregt; Luuk Gras; Kees Brinkman; Marchina van der Ende; Frank de Wolf; Lukas J A Stalpers; Jan M Prins
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  -     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Department of Internal Medicine, Diakonessenhuis, Utrecht 2Stichting HIV Monitoring, Amsterdam 3Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam 4Department of Internal Medicine, Erasmus Medical Center, Rotterdam 5Department of Radiotherapy 6Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center (AMC), Amsterdam, the Netherlands.
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