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Effect of baseline CD4 cell counts on the clinical significance of short-term immunologic response to antiretroviral therapy in individuals with virologic suppression

Moore, David M. and Harris, Ross and Lima, Viviane and Hogg, Bob and May, Margaret and Yip, Benita and Justice, Amy and Mocroft, Amanda and Reiss, Peter and Lampe, Fiona and Chêne, Geneviève and Costagliola, Dominique and Elzi, Luigia and Mugavero, Michael J. and Monforte, Antonella D'Arminio and Sabin, Caroline and Podzamczer, Daniel and Fätkenheuer, Gerd and Staszewski, Schlomo and Gill, John and Sterne, Jonathan A. C.. (2009) Effect of baseline CD4 cell counts on the clinical significance of short-term immunologic response to antiretroviral therapy in individuals with virologic suppression. Journal of acquired immune deficiency syndromes, Vol. 52. pp. 357-363.

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Official URL: http://edoc.unibas.ch/dok/A6005291

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Abstract

BACKGROUND: Achieving virologic suppression is a clear therapeutic goal for patients receiving combination antiretroviral therapy (cART). However, the effects of immunologic responses, whether measured as CD4 count changes from baseline or CD4 counts at follow-up, in patients with virologic suppression, have not been clearly established. METHODS: Treatment-naive individuals aged < or =16 years, who initiated cART between 1998 and 2005 in participating cohorts of the ART Cohort Collaboration and achieved viral load 100 cells per microliter, were 1.87 (95% confidence interval: 1.28 to 2.73), 1.60 (1.13 to 2.28), 0.98 (0.58 to 1.65) and 1.24 (0.70 to 2.18) in participants with baseline CD4 cell count or =350 cells per microliter, respectively. In contrast, hazard ratios for mortality or AIDS associated with absolute CD4 cell counts at 6 months were similar across all but the highest baseline CD4 cell count strata. CONCLUSION: It is not possible to derive thresholds for change in CD4 count that define an adequate immunologic response in individuals receiving cART. Absolute CD4 counts at 6 months are a more useful measure of immunologic response and subsequent prognosis.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Infektiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Infektiologie
UniBasel Contributors:Elzi, Luigia
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Raven Press
ISSN:0894-9255
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Feb 2013 08:46
Deposited On:01 Feb 2013 08:42

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