Factors associated with a reduced CD4 lymphocyte count response to HAART despite full viral suppression in the EuroSIDA study

Eric Florence, J. Lundgren, C. Dreezen, M. Fisher, O. Kirk, A. Blaxhult, G. Panos, C. Katlama, S. Vella, A. Phillips, J. van Lunzen, H. J. Stellbrink, S. Staszewski, F. D. Goebel, Bernd Salzberger, J. Rockstroh, J. Kosmidis, P. Gargalianos, H. Sambatakou, J. PerdiosG. Panos, I. Karydis, D. Banhegyi, F. Mulcahy, I. Yust, D. Turner, S. Pollack, Z. Ben-Ishai, Z. Bentwich, S. Maayan, S. Vella, A. Chiesi, C. Arici, R. Pristerá, F. Mazzotta, A. Gabbuti, R. Esposito, A. Bedini, A. Chirianni, E. Montesarchio, V. Vullo, P. Santopadre, P. Narciso, A. Antinori, P. Franci, M. Zaccarelli, A. Lazzarin, R. Finazzi, A. D'Arminio Monforte, L. Viksna, S. Chaplinkas, R. Hemmer, P. Reiss, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, A. Horban, D. Prokopowicz, A. Wiercinska-Drapalo, A. Boron-Kaczmarska, M. Pynka, M. Beniowski, H. Trocha, F. Antunes, K. Mansinho, R. Proenca, D. Duiculescu, M. Mikras, J. González-Lahoz, B. Diaz, T. García-Benayas, L. Martin-Carbonero, B. Clotet, A. Jou, J. Conejero, C. Tural, J. M. Gatell, J. M. Miró, A. Blaxhult, A. Karlsson, P. Pehrson, B. Ledergerber, R. Weber, P. Francioli, A. Telenti, B. Hirschel, V. Soravia-Dunand, S. Barton, A. M. Johnson, D. Mercey, C. Phillips, C. Loveday, M. A. Johnson, A. Mocroft, A. Pinching

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Objectives. To describe the prevalence and risk factors of poor CD4 count rise despite a good virological response on highly active antiretroviral treatment (HAART). Methods. The patients from the EuroSIDA study who started HAART with a baseline CD4 count of < 350 cells/μL and where all viral load (pVL) measures remained below 500 HIV-1 RNA copies/mL between 6 and 12 months after the start of HAART were included. The risk factors for poor CD4 count rise were analyzed by multiple regression. Results. Seven hundred and eighty patients were included. A low CD4 count response was observed in 225 patients (29%). The risk factors for this condition were older age, lower CD4 count at baseline, higher increase from the nadir to baseline CD4 count and lower pVL at baseline. Patients taking ≥one drug from each of the three antiviral classes were more likely to have a good CD4 response but a minority of the study participants was taking this treatment regimen (3.1%) and the confidence interval was large. Conclusions. A poor immune reconstitution despite a good virological control is frequent after initiation of HAART among patients with a baseline CD4 count of <350 cells/μL. The underlying mechanisms leading to this condition seems mainly driven by the age and the baseline immunological and virological status of the patients.

Original languageEnglish
Pages (from-to)255-262
Number of pages8
JournalHIV Medicine
Volume4
Issue number3
DOIs
Publication statusPublished - Jul 2003

Keywords

  • CD4-lymphocyte count
  • Cohort studies
  • HIV infection
  • Highly active antiretroviral therapy
  • Immune reconstitution

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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    Florence, E., Lundgren, J., Dreezen, C., Fisher, M., Kirk, O., Blaxhult, A., Panos, G., Katlama, C., Vella, S., Phillips, A., van Lunzen, J., Stellbrink, H. J., Staszewski, S., Goebel, F. D., Salzberger, B., Rockstroh, J., Kosmidis, J., Gargalianos, P., Sambatakou, H., ... Pinching, A. (2003). Factors associated with a reduced CD4 lymphocyte count response to HAART despite full viral suppression in the EuroSIDA study. HIV Medicine, 4(3), 255-262. https://doi.org/10.1046/j.1468-1293.2003.00156.x