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Title: Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy
Authors: Ku, N.S
Jiamsakul, A
Ng, O.T 
Yunihastuti, E
Cuong, D.D
Lee, M.P
Sim, B.L.H
Phanuphak, P
Wong, W.-W
Kamarulzaman, A
Zhang, F
Pujari, S
Chaiwarith, R
Oka, S
Mustafa, M
Kumarasamy, N
Van Nguyen, K
Ditangco, R
Kiertiburanakul, S
Merati, T.P
Durier, N
Choi, J.Y
TREAT Asia HIV Observational Databases (TAHO
Keywords: nonnucleoside reverse transcriptase inhibitor
anti human immunodeficiency virus agent
CD8+ T lymphocyte
hepatitis B
hepatitis C
highly active antiretroviral therapy
Human immunodeficiency virus infected patient
Human immunodeficiency virus infection
lymphocyte count
major clinical study
mixed infection
priority journal
virus load
clinical trial
combination drug therapy
drug effects
HIV Infections
lymphocyte count
middle aged
multicenter study
treatment failure
Anti-HIV Agents
CD8-Positive T-Lymphocytes
Drug Therapy, Combination
HIV Infections
Lymphocyte Count
Middle Aged
Treatment Failure
Viral Load
Issue Date: 2016
Publisher: Lippincott Williams and Wilkins
Citation: Ku, N.S, Jiamsakul, A, Ng, O.T, Yunihastuti, E, Cuong, D.D, Lee, M.P, Sim, B.L.H, Phanuphak, P, Wong, W.-W, Kamarulzaman, A, Zhang, F, Pujari, S, Chaiwarith, R, Oka, S, Mustafa, M, Kumarasamy, N, Van Nguyen, K, Ditangco, R, Kiertiburanakul, S, Merati, T.P, Durier, N, Choi, J.Y, TREAT Asia HIV Observational Databases (TAHO (2016). Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy. Medicine (United States) 95 (32) : e4570. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort. We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ?400 copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ?1200 cells/?L. Time to VF was modeled using Cox regression analysis, stratified by site. In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27%) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR = 1.35, 95% CI 1.14-1.61; P = 0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P = 0.420). This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART. Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved.
Source Title: Medicine (United States)
ISSN: 0025-7974
DOI: 10.1097/MD.0000000000004570
Rights: Attribution 4.0 International
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