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. 2011 Mar 27;25(6):819-23.
doi: 10.1097/QAD.0b013e32834625d3.

CD4 cell eligibility thresholds: an analysis of the time to antiretroviral treatment in HIV-1 seroconverters

Albert K Minga  1 , Charlotte Lewden, Delphine Gabillard, Germain I Bomisso, Thomas-d'aquin Toni, Arlette A Emième, Vincent Yapo, André Inwoley, Roger Salamon, Xavier Anglaret; Agence Nationale de Recherches sur le Sida (ANRS) 1220 Primo-CI Study Group
Collaborators, Affiliations

CD4 cell eligibility thresholds: an analysis of the time to antiretroviral treatment in HIV-1 seroconverters

Albert K Minga et al. AIDS. .

Abstract

Background: WHO recommends initiating combination antiretroviral treatment at the minimal CD4 cell threshold of 350 cells/μl. In sub-Saharan Africa, the time for a recently infected patient to reach this threshold is unclear.

Method: We estimated the probability of reaching different CD4 cell thresholds over time in the ANRS 1220 cohort of HIV-1 seroconverters in Côte d'Ivoire. CD4 cell slopes were estimated using a mixed linear model. Probabilities of crossing the 350 and 500 cells/μl CD4 cell thresholds were estimated by the Kaplan-Meier method.

Results: Between 1997 and 2009, 304 recent seroconverters have been enrolled in the Primo-CI cohort (62% men, median baseline age 29 years and median time since the estimated date of seroconversion 9 months). The probability of having a first CD4 cell count below 500 cells/μl was 0.57, 0.72, 0.79 and 0.84 at study entry, 2, 4 and 6 years, respectively. For a first CD4 cell count below 350 cells/μl, these figures were 0.29, 0.40, 0.55 and 0.67. The time for 75% of patients to reach the threshold was 3.0 years for 500 cells/μl and 7.0 years for 350 cells/μl.

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Figures

Figure 1
Figure 1. CD4 cell model validation
Blue line : predicted by the model Red line : values actually recorded in the cohort
Figure 2
Figure 2
Figure 2A: Cumulative probability of having a CD4 count below 350 cells/mm3 in recently HIV-1 infected adults, ANRS 1220 PRIMO-CI cohort 1997–2009 Figure 2B : Cumulative probability of having a CD4 count below 500 cells/mm3 in recently HIV-1 infected adults, ANRS 1220 PRIMO-CI cohort 1997–2009
Figure 2
Figure 2
Figure 2A: Cumulative probability of having a CD4 count below 350 cells/mm3 in recently HIV-1 infected adults, ANRS 1220 PRIMO-CI cohort 1997–2009 Figure 2B : Cumulative probability of having a CD4 count below 500 cells/mm3 in recently HIV-1 infected adults, ANRS 1220 PRIMO-CI cohort 1997–2009
See this image and copyright information in PMC

References

    1. WHO. Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector. Progress report. 2010 Available at: http://www.who.int/hiv/pub/2010progressreport/en/
    1. Dodd P, Garnett G, Hallett T. Examining the promise of HIV elimination by ‘test and treat’ in hyperendemic settings. AIDS. 2010;24:729–35. - PMC - PubMed
    1. Walensky RP, Wolf LL, Wood R, Fofana MO, Freedberg KA, Martinson NA, et al. When to start antiretroviral therapy in resource-limited settings. Ann Intern Med. 2009;151:157–66. - PMC - PubMed
    1. Granich R, Gilks C, Dye C, De Cock K, Williams B. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57. - PubMed
    1. The ART-LINC Collaboration of International Databases to Evaluate AIDS (IeDEA) Keiser O, Anastos K, Schechter M, Balestre E, Boulle A, et al. Antiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Trop Med Int Health. 2008;13:870–9. - PMC - PubMed

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