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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11140/19:10409700

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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 &gt;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 &lt;50 cells/mm(3) from baseline after 8 months despite viral load of &lt;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 &lt; 0.001), and lower HIV RNA levels (OR, 1.93 per log(10) decrease; P &lt; 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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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 &gt;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 &lt;50 cells/mm(3) from baseline after 8 months despite viral load of &lt;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 &lt; 0.001), and lower HIV RNA levels (OR, 1.93 per log(10) decrease; P &lt; 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30303 - Infectious Diseases

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Acquired Immune Deficiency Syndromes

ISSN

1525-4135

e-ISSN

—

Svazek periodika

81

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

8

Strana od-do

10-17

Kód UT WoS článku

000480770000012

EID výsledku v databázi Scopus

2-s2.0-85064721999