Repositório Digital

A- A A+

Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings

.

Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings

Mostrar registro completo

Estatísticas

Título Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings
Autor Calmy, Alexandra
Balestre, Eric
Bonnet, Fabrice
Boulle, Andrew
Sprinz, Eduardo
Wood, Robin
Delaporte, Eric
Messou, Eugène
McIntyre, James
El Filaili, Kamal Marhoum
Schechter, Mauro
Kumarasamy, Nagalingeswaran
Bangsberg, David R.
Macphail, Patrick
Borght, Stefaan Van Der
Zala, Carlos
Egger, Matthias
Thiébaut, Rodolphe
Dabis, François
Abstract Background: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART. Method: Naïve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART. Results: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/μL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12. Conclusion: In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.
Contido em BMC infectious diseases. London. Vol. 12, [article] 147 (Jun. 2012), 9 p.
Assunto Anti-retrovirais
Contagem de linfócito CD4
HIV-1
Terapia anti-retroviral de alta atividade
[en] CD4 count
[en] CD4 slope
[en] HIV-1
[en] HIV-RNA threshold
[en] Resource limited settings
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/111604
Arquivos Descrição Formato
000855165.pdf (249.1Kb) Texto completo (inglês) Adobe PDF Visualizar/abrir

Este item está licenciado na Creative Commons License

Este item aparece na(s) seguinte(s) coleção(ões)


Mostrar registro completo

Percorrer



  • O autor é titular dos direitos autorais dos documentos disponíveis neste repositório e é vedada, nos termos da lei, a comercialização de qualquer espécie sem sua autorização prévia.
    Projeto gráfico elaborado pelo Caixola - Clube de Criação Fabico/UFRGS Powered by DSpace software, Version 1.8.1.