. 2021 Oct 5;73(7):e2334-e2337.

doi: 10.1093/cid/ciaa1904.

CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018

Jennifer S Lee¹, Elizabeth A Humes¹, Brenna C Hogan¹, Kate Buchacz², Joseph J Eron³, M John Gill⁴, Timothy R Sterling⁵, Peter F Rebeiro^{5

6}, Viviane Dias Lima⁷, Angel Mayor⁸, Michael J Silverberg⁹, Michael A Horberg¹⁰, Richard D Moore¹¹, Keri N Althoff¹; North American AIDS Cohort Collaboration on Research and Design

Collaborators, Affiliations

Collaborators

North American AIDS Cohort Collaboration on Research and Design:
Constance A Benson, Ronald J Bosch, Gregory D Kirk Emory-Grady, Kenneth H Mayer, Chris Grasso, Robert S Hogg, P Richard Harrigan, Julio S G Montaner, Benita Yip, Julia Zhu, Kate Salters, Karyn Gabler, Kate Buchacz, Jun Li, Kelly A Gebo, Richard D Moore Johns, Richard D Moore, John T Carey, Benigno Rodriguez, Michael A Horberg, Michael J Silverberg, Jennifer E Thorne, Todd Brown, Phyllis Tien, Gypsyamber D'Souza, Frederic Crouzat, Mona Loutfy, Graham Smith, Meenakshi Gupta, Marina B Klein, Charles Rabkin, Abigail Kroch, Ann Burchell, Adrian Betts, Joanne Lindsay, Ank Nijhawan, Robert F Hunter-Mellado, Angel M Mayor, M John Gill, Jeffrey N Martin, Jun Li, John T Brooks, Michael S Saag, Michael J Mugavero, James Willig, Laura Bamford, Maile Karris, Joseph J Eron, Sonia Napravnik, Mari M Kitahata, Heidi M Crane, Timothy R Sterling, David Haas, Peter Rebeiro, Megan Turner, Lesley Park, Amy Justice, Richard D Moore, Keri N Althoff, Stephen J Gange, Mari M Kitahata, Jennifer S Lee, Michael S Saag, Michael A Horberg, Marina B Klein, Rosemary G McKaig, Aimee M Freeman, Richard D Moore, Keri N Althoff, Aimee M Freeman, Mari M Kitahata, Stephen E Van Rompaey, Heidi M Crane, Liz Morton, Justin McReynolds, William B Lober, Stephen J Gange, Jennifer S Lee, Brenna Hogan, Bin You, Elizabeth Humes, Lucas Gerace, Cameron Stewart, Sally Coburn

Affiliations

¹ Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
² Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
³ Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Southern Alberta HIV Clinic, Calgary, Alberta, Canada.
⁵ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁶ Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁷ BC Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Medicine, Universidad Central del Caribe, Bayamon, Puerto Rico.
⁹ Kaiser Permanente Northern California, Oakland, California, USA.
¹⁰ Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA.
¹¹ Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 33383586
PMCID: PMC8492212
DOI: 10.1093/cid/ciaa1904

CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018

Jennifer S Lee et al. Clin Infect Dis. 2021.

. 2021 Oct 5;73(7):e2334-e2337.

doi: 10.1093/cid/ciaa1904.

Authors

Collaborators

North American AIDS Cohort Collaboration on Research and Design:
Constance A Benson, Ronald J Bosch, Gregory D Kirk Emory-Grady, Kenneth H Mayer, Chris Grasso, Robert S Hogg, P Richard Harrigan, Julio S G Montaner, Benita Yip, Julia Zhu, Kate Salters, Karyn Gabler, Kate Buchacz, Jun Li, Kelly A Gebo, Richard D Moore Johns, Richard D Moore, John T Carey, Benigno Rodriguez, Michael A Horberg, Michael J Silverberg, Jennifer E Thorne, Todd Brown, Phyllis Tien, Gypsyamber D'Souza, Frederic Crouzat, Mona Loutfy, Graham Smith, Meenakshi Gupta, Marina B Klein, Charles Rabkin, Abigail Kroch, Ann Burchell, Adrian Betts, Joanne Lindsay, Ank Nijhawan, Robert F Hunter-Mellado, Angel M Mayor, M John Gill, Jeffrey N Martin, Jun Li, John T Brooks, Michael S Saag, Michael J Mugavero, James Willig, Laura Bamford, Maile Karris, Joseph J Eron, Sonia Napravnik, Mari M Kitahata, Heidi M Crane, Timothy R Sterling, David Haas, Peter Rebeiro, Megan Turner, Lesley Park, Amy Justice, Richard D Moore, Keri N Althoff, Stephen J Gange, Mari M Kitahata, Jennifer S Lee, Michael S Saag, Michael A Horberg, Marina B Klein, Rosemary G McKaig, Aimee M Freeman, Richard D Moore, Keri N Althoff, Aimee M Freeman, Mari M Kitahata, Stephen E Van Rompaey, Heidi M Crane, Liz Morton, Justin McReynolds, William B Lober, Stephen J Gange, Jennifer S Lee, Brenna Hogan, Bin You, Elizabeth Humes, Lucas Gerace, Cameron Stewart, Sally Coburn

Affiliations

¹ Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
² Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
³ Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Southern Alberta HIV Clinic, Calgary, Alberta, Canada.
⁵ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁶ Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁷ BC Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Medicine, Universidad Central del Caribe, Bayamon, Puerto Rico.
⁹ Kaiser Permanente Northern California, Oakland, California, USA.
¹⁰ Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA.
¹¹ Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 33383586
PMCID: PMC8492212
DOI: 10.1093/cid/ciaa1904

Abstract

From 2005 to 2018, among 32013 adults with human immunodeficiency virus entering care, median time to antiretroviral therapy (ART) prescription declined from 69 to 6 days, CD4 count at entry into care increased from 300 to 362 cells/μL, and CD4 count at ART prescription increased from 160 to 364 cells/μL.

Keywords: CD4 count; HIV; antiretroviral therapy; treat all; universal treatment.

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Figures

**Figure 1.**
Median CD4 count at entry into care (black circles) and at antiretroviral therapy (ART) prescription (red triangles) overlaying median days from entry into care to ART prescription (blue bars) by calendar year.

See this image and copyright information in PMC

References

1. Kitahata MM, Gange SJ, Abraham AG, et al. ; NA-ACCORD Investigators . Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med 2009; 360:1815–26. - PMC - PubMed
1. Panel of Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at https://aidsinfo.nih.gov/guidelines/archive/adult-and-adolescent-guideli.... Accessed 29 July 2020.
1. World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV;2015. Available at https://apps.who.int/iris/handle/10665/186275. Accessed 31 July 2020.
1. Gange SJ, Kitahata MM, Saag MS, et al. Cohort profile: the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Int J Epidemiol 2007; 36:294–301. - PMC - PubMed
1. Althoff KN, Buchacz K, Hall HI, et al. U.S. trends in antiretroviral therapy use, HIV RNA plasma viral loads, and CD4 T-lymphocyte cell counts among HIV-infected persons, 2000 to 2008. Ann Intern Med 2012; 157:325–35. - PMC - PubMed

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CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018

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CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018

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