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Factors
Influencing Increases in CD4 Cell Counts of HIV Positive Persons
Receiving Long-Term HAART
Highly active antiretroviral therapy (HAART) results in an improvement
in immunologic function. Researchers at the Royal Free Hospital in London sought to investigate the
factors associated with increases in CD4
cell count among HIVpositive antiretroviral-naive
patients starting HAART.
Five
hundred ninety-six subjects were followed for a
median of 2.5 years (interquartile range, 1.0 4.0 years).
Factors associated with changes in CD4 cell counts
in the first 3 months of HAART and from 3
months onwards were analyzed.
Results
After
6, 12, and 24 months of HAART, the median increases in CD4 cell counts were 114, 181, and 248 cells/mm3, respectively.
84%,
84%, and 80% of subjects had a virus load
of <400 copies/mL during the same periods.
White ethnicity,
higher pre-HAART virus load, and lower pre-HAART
CD4 and CD8 cell counts were associated with
greater increases in CD4 cell counts during
the first 3 months of HAART.
From 3 months onward, a greater cumulative proportion
of time spent with virus load <400 copies/mL
was associated with a more favorable change
in CD4 cell count (an average increase of
5.2 cells/mm3/year for each extra 10% cumulative
time spent with a virus load <400 copies/mL)
(P < .0001).
For
every 100 cells/mm3 higher in baseline
CD4 cell count, the increase was 6 cells/mm3/year
less (95% CI, 211 cells/mm3/year)
(P = .02). Sex, risk group, age, and
HAART regimen were not associated with increases
in CD4 cell counts.
Conclusions
The
authors conclude, “These findings emphasize the importance
of maintaining virological suppression and suggest other factors that influence long-term CD4 cell response.”
Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences and Department of Immunology and Molecular Pathology, Royal Free and University College Medical School, Royal Free Campus, and Department of Thoracic Medicine and Department of Infectious Diseases, Royal Free Hospital, London, United Kingdom.
10/25/04
Reference
C J Smith
and others. Factors Influencing Increases in CD4 Cell Counts of HIV-Positive Persons Receiving Long-Term Highly Active Antiretroviral Therapy. The Journal of Infectious Diseases 190(10): 1860-1868. November 15, 2004.
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