Abstract
Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.
| Original language | English |
|---|---|
| Article number | 361 |
| Journal | BMC Infectious Diseases |
| Volume | 10 |
| DOIs | |
| Publication status | Published - 2010 Dec 23 |
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All Science Journal Classification (ASJC) codes
- Infectious Diseases
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Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment : Results from The TREAT Asia HIV Observational Database. / Zhou, Jialun; Sirisanthana, Thira; Kiertiburanakul, Sasisopin; Chen, Yi Ming A.; Han, Ning; Lim, Poh Lian; Kumarasamy, Nagalingeswaran; Choi, JunYong; Merati, Tuti P.; Yunihastuti, Evy; Oka, Shinichi; Kamarulzaman, Adeeba; Phanuphak, Praphan; Lee, Christopher K.C.; Li, Patrick C.K.; Pujari, Sanjay; Saphonn, Vanthanak; Law, Matthew G.
In: BMC Infectious Diseases, Vol. 10, 361, 23.12.2010.Research output: Contribution to journal › Article
TY - JOUR
T1 - Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment
T2 - Results from The TREAT Asia HIV Observational Database
AU - Zhou, Jialun
AU - Sirisanthana, Thira
AU - Kiertiburanakul, Sasisopin
AU - Chen, Yi Ming A.
AU - Han, Ning
AU - Lim, Poh Lian
AU - Kumarasamy, Nagalingeswaran
AU - Choi, JunYong
AU - Merati, Tuti P.
AU - Yunihastuti, Evy
AU - Oka, Shinichi
AU - Kamarulzaman, Adeeba
AU - Phanuphak, Praphan
AU - Lee, Christopher K.C.
AU - Li, Patrick C.K.
AU - Pujari, Sanjay
AU - Saphonn, Vanthanak
AU - Law, Matthew G.
PY - 2010/12/23
Y1 - 2010/12/23
N2 - Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.
AB - Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.
UR - http://www.scopus.com/inward/record.url?scp=78651492845&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78651492845&partnerID=8YFLogxK
U2 - 10.1186/1471-2334-10-361
DO - 10.1186/1471-2334-10-361
M3 - Article
C2 - 21182796
AN - SCOPUS:78651492845
VL - 10
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
M1 - 361
ER -