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Title: 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
Authors: Zhou, J
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
Keywords: antiretrovirus agent
efavirenz plus lamivudine plus stavudine
efavirenz plus lamivudine plus zidovudine
lamivudine plus nevirapine plus stavudine
lamivudine plus nevirapine plus zidovudine
unclassified drug
age distribution
CD4 lymphocyte count
concurrent infection
controlled study
data base
disease classification
hepatitis B
hepatitis C
HIV test
Human immunodeficiency virus infected patient
Human immunodeficiency virus infection
major clinical study
mixed infection
treatment duration
trend study
virus load
clinical trial
highly active antiretroviral therapy
Human immunodeficiency virus infection
multicenter study
statistical model
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
HIV Infections
Linear Models
Viral Load
Issue Date: 2010
Citation: Zhou, J, 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 : 361. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
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. © 2010 Zhou et al; licensee BioMed Central Ltd.
Source Title: BMC Infectious Diseases
ISSN: 14712334
DOI: 10.1186/1471-2334-10-361
Rights: Attribution 4.0 International
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