Risk Factors for Low CD4(+) Count Recovery Despite Viral Suppression Among Participants Initiating Antiretroviral Treatment With CD4(+) Counts > 500 Cells/mm(3): Findings From the Strategic Timing of AntiRetroviral Therapy (START) Trial
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00669806%3A_____%2F19%3A10409700" target="_blank" >RIV/00669806:_____/19:10409700 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11140/19:10409700
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=m6S8WHVc2w" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=m6S8WHVc2w</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1097/QAI.0000000000001967" target="_blank" >10.1097/QAI.0000000000001967</a>
Alternative languages
Result language
angličtina
Original language name
Risk Factors for Low CD4(+) Count Recovery Despite Viral Suppression Among Participants Initiating Antiretroviral Treatment With CD4(+) Counts > 500 Cells/mm(3): Findings From the Strategic Timing of AntiRetroviral Therapy (START) Trial
Original language description
Background: Low CD4(+) recovery among HIV-positive individuals who achieve virologic suppression is common but has not been studied among individuals initiating treatment at CD4(+) counts of >500 cells/mm(3). Setting: United States, Africa, Asia, Europe and Israel, Australia, Latin America. Methods: Among participants randomized to immediate antiretroviral therapy (ART) in the Strategic Timing of AntiRetroviral Therapy trial, low CD4(+) recovery was defined as a CD4(+) increase of <50 cells/mm(3) from baseline after 8 months despite viral load of <200 copies/mL. Risk factors for low recovery were investigated with logistic regression. Results: Low CD4(+) recovery was observed in 39.7% of participants. Male sex [odds ratio (OR), 1.53; P = 0.007], lower screening CD4(+) cell counts (OR, 1.09 per 100 fewer cells/mm(3); P = 0.004), higher baseline CD8(+) cell counts (OR, 1.05 per 100 more cells/mm(3); P < 0.001), and lower HIV RNA levels (OR, 1.93 per log(10) decrease; P < 0.001) were associated with low CD4(+) recovery. D-dimer had a quadratic association with low CD4(+) recovery, with lowest odds occurring at 0.32 mu g/mL. At lower HIV RNA levels, the odds of low CD4(+) recovery were elevated across the levels of screening CD4(+) count; but at higher HIV RNA levels, the odds of low CD4(+) recovery were higher among those with lower vs. higher screening CD4(+). Conclusions: Low CD4(+) recovery is frequent among participants starting ART at high CD4(+) counts. Risk factors include male sex, lower screening CD4(+) cell counts, higher CD8(+) cell counts, and lower HIV RNA levels. More follow-up is required to determine the impact of low CD4(+) recovery on clinical outcomes.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30303 - Infectious Diseases
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Acquired Immune Deficiency Syndromes
ISSN
1525-4135
e-ISSN
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Volume of the periodical
81
Issue of the periodical within the volume
1
Country of publishing house
US - UNITED STATES
Number of pages
8
Pages from-to
10-17
UT code for WoS article
000480770000012
EID of the result in the Scopus database
2-s2.0-85064721999