CD4 cell counts of 800 cells/mm3 or greater after 7 years of highly active antiretroviral therapy are feasible in most patients starting with 350 cells/mm3 or greater
L Gras, AM Kesselring, JT Griffin… - JAIDS Journal of …, 2007 - journals.lww.com
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2007•journals.lww.com
Objective: CD4 cell count changes in therapy-naive patients were investigated during 7
years of highly active antiretroviral therapy (HAART) in an observational cohort. Methods:
Three endpoints were studied:(1) time to≥ 800 CD4 cells/mm 3 in 5299 therapy-naive
patients starting HAART,(2) CD4 cell count changes during 7 years of uninterrupted HAART
in a subset of 544 patients, and (3) reaching a plateau in CD4 cell restoration after 5 years of
HAART in 366 virologically suppressed patients. Results: Among patients with< 50, 50 to …
years of highly active antiretroviral therapy (HAART) in an observational cohort. Methods:
Three endpoints were studied:(1) time to≥ 800 CD4 cells/mm 3 in 5299 therapy-naive
patients starting HAART,(2) CD4 cell count changes during 7 years of uninterrupted HAART
in a subset of 544 patients, and (3) reaching a plateau in CD4 cell restoration after 5 years of
HAART in 366 virologically suppressed patients. Results: Among patients with< 50, 50 to …
Abstract
Objective:
CD4 cell count changes in therapy-naive patients were investigated during 7 years of highly active antiretroviral therapy (HAART) in an observational cohort.
Methods:
Three endpoints were studied:(1) time to≥ 800 CD4 cells/mm 3 in 5299 therapy-naive patients starting HAART,(2) CD4 cell count changes during 7 years of uninterrupted HAART in a subset of 544 patients, and (3) reaching a plateau in CD4 cell restoration after 5 years of HAART in 366 virologically suppressed patients.
Results:
Among patients with< 50, 50 to 200, 200 to 350, 350 to 500, and≥ 500 CD4 cells/mm 3 at baseline, respectively, 20%, 26%, 46%, 73%, and 87% reached≥ 800 CD4 cells/mm 3 within 7 years of starting HAART. Periods with HIV RNA levels> 500 copies/mL and age≥ 50 years were associated with lesser increases in CD4 cell counts between 6 months and 7 years. Having reached≥ 800 CD4 cells/mm 3 at 5 years, age≥ 50 years, and≥ 1 HIV RNA measurement> 1000 copies/mL between 5 and 7 years were associated with a plateau in CD4 cell restoration.
Conclusions:
Restoration to CD4 cell counts≥ 800 cells/mm 3 is feasible within 7 years of HAART in most HIV-infected patients starting with≥ 350 cells/mm 3 and achieving sufficient suppression of viral replication. Particularly in patients≥ 50 years of age, it may be beneficial to start earlier than current guidelines recommend.
Lippincott Williams & Wilkins