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. 2017 Oct 2;12(10):e0184441.
doi: 10.1371/journal.pone.0184441. eCollection 2017.

Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4

Sophie Grabar  1   2   3 , Hana Selinger-Leneman  1 , Sophie Abgrall  1   2   3   4   5 , Gilles Pialoux  6   7 , Laurence Weiss  3   8 , Dominique Costagliola  1
Affiliations

Loss of long-term non-progressor and HIV controller status over time in the French Hospital Database on HIV - ANRS CO4

Sophie Grabar et al. PLoS One. .

Abstract

Objectives: We studied the frequency and risk factors for loss of long-term non-progressor (LTNP) and HIV controller (HIC) status among patients identified as such in 2005 in the French Hospital Database on HIV (FHDH-ANRS CO4).

Methods: We selected patients who were treatment-naïve and asymptomatic in 2005 (baseline). Those with ≥8 years of known HIV infection and a CD4 cell nadir ≥500/mm3 were classified as LTNP and those with ≥10 years of known HIV infection and 90% of plasma viral load (VL) values ≤500 copies/ml in the absence of cART as HIC. cART initiation without loss of status and death from non AIDS-defining causes were considered as competing events.

Results: After 5 years of follow-up, 33% (95%CI; 27-42) of 171 LTNP patients and 17% (95%CI; 10-30) of 72 HIC patients had lost their status. In multivariable analyses, loss of LTNP status was associated with lower baseline CD4 cell counts and CD4/CD8 ratios. Only VL was significantly associated with loss of HIC status after adjustment for the baseline CD4 cell count, the CD4/CD8 ratio, and concomitant LTNP status. The hazard ratio for loss of HIC status was 5.5 (95%CI, 1.5-20.1) for baseline VL 50-500 vs ≤50 cp/mL, after adjustment for the baseline CD4 cell count.

Conclusions: One-third of LTNP and one-fifth of HIC patients lost their status after 5 years of follow-up, raising questions as to the possible benefits and timing of ART initiation in these populations.

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Conflict of interest statement

Competing Interests: Dominique Costagliola was a member of the French Gilead HIV board up to 2015. In the past 3 years, she gave lectures for Janssen-Cilag, Merck-Sharp & Dohme-Chibret, ViiV and received travel/accommodations/meeting expenses from Gilead, ViiV, Janssen-Cilag. She conducted post-marketing studies for Janssen-Cilag, Merck-Sharp & Dohme-Chibret and ViiV. She is currently a consultant for Innavirvax. Laurence Weiss was a member of the Advisory board for Bristol Myers Squibb (up to 2015), of the Regional Advisory board Gilead (2016). In the past 3 years, he gave lectures for Janssen-Cilag, Merck-Sharp & Dohme-Chibret and received travel/accommodations/meeting expenses from Gilead, Bristol Myers Squibb, and Janssen-Cilag. He is currently a consultant for Bristol Myers Squibb (immune-oncology). Sophie Abgrall is a member of the French Janssen-Cilag board. In the past 3 years, she gave lectures for Gilead and ViiV, and received travel/accommodations expenses from Gilead, ViiV and Janssen-Cilag. Sophie Grabar gave a lecture for Gilead. Gilles Pialoux have received research grants from Gilead and BMS. He participated on advisory boards or received travel/accommodations expenses from Gilead, MSD, Janssen, BMS, Abbvie and ViiVhealthcare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1
Cumulative incidence of loss of LTNP (panel A) and HIV controller (panel B) status, treatment initiation and non AIDS deaths since 2005. A: Long-term non-progressors (n = 171). B: HIV controllers (n = 72).
See this image and copyright information in PMC

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