Does discordancy between the CD4 count and CD4 percentage in HIV-positive individuals influence outcomes on highly active antiretroviral therapy?

Gompels, Mark, Dunn, David T, Phillips, Andrew, Dooley, Debbie, De Burgh Thomas, Andrew, Anderson, Jane, Post, Frank, Pillay, Deenan, Gazzard, Brian, Hill, Teresa, Johnson, Margaret, Gilson, Richard, Bansi, Loveleen, Easterbrook, Philippa, Fisher, Martin, Walsh, John, Orkin, Chloe, Ainsworth, Jonathan, Leen, Clifford, Sabin, Caroline and The UK Collaborative HIV Cohort (UK CHIC) Study (Appendix), (2012) Does discordancy between the CD4 count and CD4 percentage in HIV-positive individuals influence outcomes on highly active antiretroviral therapy? Journal of Infectious Diseases, 205 (4). pp. 540-547. ISSN 0022-1899

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Abstract

INTRODUCTION

The CD4 count and CD4 percentage (CD4%) are both strong predictors of clinical disease progression in human immunodeficiency virus (HIV). Although individuals may show discordancy between their CD4 count and CD4%, the clinical relevance of this is unclear.

METHODS

Discordancy was defined where the CD4% was ≤10th percentile for a selected CD4 count range (referred to as low discordancy), within the central 80% range (concordant), or ≥90th percentile (high discordancy). Regression methods identified factors associated with low and high discordancy in untreated individuals and assessed the impact of discordancy on treatment responses to highly active antiretroviral therapy (HAART).

RESULTS

High discordancy was associated with female sex, low viral load, and white ethnicity; low discordancy was associated with black or nonwhite ethnicity, older age, and injection drug use. Clinical event rates were higher in individuals with high discordancy starting HAART, but there was no association with subsequent HIV progression by 6 months after starting HAART. CD4 count increases remained lower, by 20 cells/mm(3), in individuals with low discordancy, and higher, by 27 cells/mm(3), in those with high discordancy.

CONCLUSIONS

Overall discrepancies between the CD4/CD4% are small, confirming the use of absolute CD4 counts as a monitoring tool.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
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Depositing User: Ellen Thomas
Date Deposited: 13 Dec 2013 14:46
Last Modified: 13 Dec 2013 14:46
URI: http://sro.sussex.ac.uk/id/eprint/47087
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