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CD4(+) T-cell recovery after initiation of antiretroviral therapy in a resource-limited setting: a prospective cohort analysis.

Abstract：

BACKGROUND:CD4(+) T-cell count recovery after antiretroviral therapy (ART) initiation is associated with improved health outcomes. It is unknown how the CD4(+) T-cell counts of African HIV patients recover following ART initiation. METHODS:We examined CD4(+) T-cell count recovery in a large cohort of HIV-positive patients initiating ART in Uganda between 2004 and 2011. We categorized patients according to their CD4(+) T-cell count at ART initiation. All patients received CD4(+) T-cell count evaluations on a biannual basis. We used quantile regression to model the recovery of CD4(+) T-cells during ART. RESULTS:A total of 5,271 patients aged ≥14 years at baseline were included. The median number of CD4(+) T-cell count measurements was 6 (IQR 4-8), and vital status at censoring was known in 97.2% of individuals. Most CD4(+) T-cell count recovery occurred within the first 12 months, with marginal increases beyond 18 months and stabilization after 5 years. The strongest predictor of CD4(+) T-cell count recovery was baseline CD4(+) T-cell count. After 5 years on treatment, the median CD4(+) T-cell count was 334 cells/mm(3) for patients initiating ART with <100 cells/mm(3). Only those initiating ART with >200 cells/mm(3) reached a 5-year median >500 cells/mm(3). Adolescents had the most robust CD4(+) T-cell count recovery with a median increase after 12 months that was 109 cells/mm(3) greater than those initiating ART at age ≥50 years. CONCLUSIONS:In individuals from a resource-limited setting, baseline CD4(+) T-cell count was highly predictive of the maximum CD4(+) T-cell count level achieved while on ART.

journal_name

Antivir Ther

journal_title

Antiviral therapy

authors

Kanters S,Nachega J,Funk A,Mukasa B,Montaner JS,Ford N,Bucher HC,Mills EJ

doi

10.3851/IMP2670

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

31-9

issue

1

eissn

1359-6535

issn

2040-2058

journal_volume

19

pub_type

杂志文章

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