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, J.L.; Sirisanthana, T.; Kiertiburanakul, S.; Chen, Y.M.A.; Han, N.; Lim, P.L.; Kumarasamy, N.; Choi, J.Y.; Merati, T.P.; Yunihastuti, E.; Oka, S.; Kamarulzaman, A.; Phanuphak, P.; Lee, C.K.C.; Li, P.C.K.; Pujari, S.; Saphonn, V.; Law, M.G. (2010) 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. BMC Infectious Diseases, 10. ISSN 1471-2334

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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.

Item Type: Article
Creators:
  1. Zhou, J.L.
  2. Sirisanthana, T.
  3. Kiertiburanakul, S.
  4. Chen, Y.M.A.
  5. Han, N.
  6. Lim, P.L.
  7. Kumarasamy, N.
  8. Choi, J.Y.
  9. Merati, T.P.
  10. Yunihastuti, E.
  11. Oka, S.
  12. Kamarulzaman, A.(Department of Medicine, Faculty of Medicine Building, University of Malaya, 50603 Kuala Lumpur, MALAYSIA)
  13. Phanuphak, P.
  14. Lee, C.K.C.
  15. Li, P.C.K.
  16. Pujari, S.
  17. Saphonn, V.
  18. Law, M.G.
Journal or Publication Title: BMC Infectious Diseases
Additional Information: Zhou, Jialun Sirisanthana, Thira Kiertiburanakul, Sasisopin Chen, Yi-Ming A. Han, Ning Lim, Poh Lian Kumarasamy, Nagalingeswaran Choi, Jun Yong Merati, Tuti Parwati Yunihastuti, Evy Oka, Shinichi Kamarulzaman, Adeeba Phanuphak, Praphan Lee, Christopher K. C. Li, Patrick C. K. Pujari, Sanjay Saphonn, Vanthanak Law, Matthew G.
Uncontrolled Keywords: HIV
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms azrahani halim
Date Deposited: 04 Feb 2013 13:54
Last Modified: 14 Jul 2017 15:08
URI: http://eprints.um.edu.my/id/eprint/4624

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