Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy

TREAT Asia HIV Observational Databases (TAHOD)

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort. We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ≥400 copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ≥1200 cells/μL. Time to VF was modeled using Cox regression analysis, stratified by site. In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27%) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR = 1.35, 95% CI 1.14-1.61; P = 0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P = 0.420). This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART.

Original languageEnglish
Article numbere4570
JournalMedicine (United States)
Volume95
Issue number32
DOIs
Publication statusPublished - 2016 Aug 1

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Cell Count
HIV
T-Lymphocytes
Viral Load
Therapeutics
Treatment Failure
Regression Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy",
abstract = "Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort. We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ≥400 copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ≥1200 cells/μL. Time to VF was modeled using Cox regression analysis, stratified by site. In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27{\%}) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR = 1.35, 95{\%} CI 1.14-1.61; P = 0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P = 0.420). This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART.",
author = "{TREAT Asia HIV Observational Databases (TAHOD)} and Ku, {Nam Su} and Awachana Jiamsakul and Ng, {Oon Tek} and Evy Yunihastuti and Cuong, {Do Duy} and Lee, {Man Po} and Sim, {Benedict Lim Heng} and Praphan Phanuphak and Wong, {Wing Wai} and Adeeba Kamarulzaman and Fujie Zhang and Sanjay Pujari and Romanee Chaiwarith and Shinichi Oka and Mahiran Mustafa and Nagalingeswaran Kumarasamy and {Van Nguyen}, Kinh and Rossana Ditangco and Sasisopin Kiertiburanakul and Merati, {Tuti Parwati} and Nicolas Durier and Choi, {Jun Yong}",
year = "2016",
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language = "English",
volume = "95",
journal = "Medicine (United States)",
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Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy. / TREAT Asia HIV Observational Databases (TAHOD).

In: Medicine (United States), Vol. 95, No. 32, e4570, 01.08.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy

AU - TREAT Asia HIV Observational Databases (TAHOD)

AU - Ku, Nam Su

AU - Jiamsakul, Awachana

AU - Ng, Oon Tek

AU - Yunihastuti, Evy

AU - Cuong, Do Duy

AU - Lee, Man Po

AU - Sim, Benedict Lim Heng

AU - Phanuphak, Praphan

AU - Wong, Wing Wai

AU - Kamarulzaman, Adeeba

AU - Zhang, Fujie

AU - Pujari, Sanjay

AU - Chaiwarith, Romanee

AU - Oka, Shinichi

AU - Mustafa, Mahiran

AU - Kumarasamy, Nagalingeswaran

AU - Van Nguyen, Kinh

AU - Ditangco, Rossana

AU - Kiertiburanakul, Sasisopin

AU - Merati, Tuti Parwati

AU - Durier, Nicolas

AU - Choi, Jun Yong

PY - 2016/8/1

Y1 - 2016/8/1

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AB - Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort. We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ≥400 copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ≥1200 cells/μL. Time to VF was modeled using Cox regression analysis, stratified by site. In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27%) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR = 1.35, 95% CI 1.14-1.61; P = 0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P = 0.420). This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART.

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