Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008:2:3-9.
doi: 10.2174/1874613600802010003. Epub 2008 Feb 12.

Clinical progression rates by CD4 cell category before and after the initiation of combination antiretroviral therapy (cART)

Marguerite Guiguet  1 , Kholoud Porter, Andrew Phillips, Dominique Costagliola, Abdel Babiker
Affiliations

Clinical progression rates by CD4 cell category before and after the initiation of combination antiretroviral therapy (cART)

Marguerite Guiguet et al. Open AIDS J. 2008.

Abstract

Objective: Rates of AIDS defining event (ADE), serious ADE and death by CD4 and HIV RNA categories before and after combination antiretroviral therapy (cART) initiation are lacking for high CD4 counts.

Methods: Event rates were estimated within CD4 cell strata using a Poisson regression model adjusting for sex, exposure category, age, and current HIV RNA (<4, 4-4.99, > or =5 log copies/ml), and including an interaction term between the CD4 cell count and cART indicator.

Results: 7317 and 6376 persons contributed to "naïve " and "cART " groups respectively, of whom 3911 contributed to both. At the same CD4 level, the risk of ADE was nearly 2 fold higher during naive follow-up compared to cART for CD4 <500 cells/mm(3). However, after adjustment for current HIV RNA, the risk of ADE became similar for both groups except for CD4 count <200 cells/mm(3) when it is 35% (6-72%) higher for naives. The same results were observed for the risk of serious ADE. There was no evidence of a difference in risk of death between naive and cART follow-up at specific CD4 categories even after adjustment for HIV RNA.

Conclusion: Within CD4 cell strata above 200 cells/mm(3), the risk of ADE before ART initiation is higher than it is following cART initiation.

Keywords: CD4; Disease progression; cART; event rates; prognostic value..

PubMed Disclaimer

Figures

Figures (1)
Figures (1)
Estimates of rates and 95%CI of (a) AIDS-defining event (ADE), (b) serious ADE, (c) death, before (circle) and after (square) initiation of combination anti-retroviral therapy (cART) using Poisson regression model adjusting on age and exposure category/sex (hollow symbol), or adjusting on age, exposure category/sex and current HIV RNA strata (solid symbol), with an interaction term between cART indicator and CD4 strata
See this image and copyright information in PMC

References

    1. The Strategies for Management of Antiretroviral Therapy (SMART) Study Group. CD4+ count-guided interruption of antiretroviral treatment. New Engl J Med. 2006;355:2283–96. - PubMed
    1. Phillips A, Gazzard B, Clumeck N, Losso M, Lundgren J. When should antiretroviral therapy for HIV be started? BMJ. 2007;334:76–78. - PMC - PubMed
    1. Rahat M. The UK Collaborative HIV Cohort (CHIC) Study Steering Committee. Rate of AIDS diseases or death in HIV-infected antiretroviral therapy-naive individuals with high CD4 cell count. Aids. 2007;21:1717–1721. - PubMed
    1. CASCADE Collaboration.Changes in the uptake of antiretroviral therapy and survival in people with known duration of HIV infection in Europe : results from CASCADE. HIV Med. 2000;1:224–231. - PubMed
    1. CASCADE Collaboration.Short-term risk of AIDS according to current CD4 cell count and viral load in antiretroviral drug-naive individuals and those treated in the monotherapy era. Aids. 2004;18:1–58. - PubMed

LinkOut - more resources