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Long-term trends in CD4 cell counts and impact of viral failure in individuals starting antiretroviral therapy: UK Collaborative HIV Cohort (CHIC) study

journal contribution
posted on 2023-06-08, 16:41 authored by R A Hughes, J A C Sterne, J Walsh, L Bansi, R Gilson, C Orkin, T Hill, J Ainsworth, J Anderson, M Gompels, D Dunn, M A Johnson, A N Phillips, D Pillay, C Leen, P Easterbrook, B Gazzard, M Fisher, C A Sabin
OBJECTIVE The aim of the study was to describe trends in CD4 cell counts in HIV-infected patients after initiation of combination antiretroviral therapy (cART), according to CD4 cell count at initiation (baseline), and to quantify the implications of virological failure for these trends. METHODS Eligible participants from the UK Collaborative HIV Cohort (CHIC) were antiretroviralnaïve and started cART after 1997. Random effects were used to model CD4 cell count trends, accounting for multiple measurements within participants. We assessed whether CD4 cell count trends varied according to baseline CD4 cell count and separately in participants with and without post-cART virological failure. Effects of post-cART virological failure (>1000 HIV-1 RNA copies/mL) on subsequent CD4 cell counts were evaluated. FINDINGS A total of 7069 participants were included in the analysis (median follow-up in all baseline CD4 cell count groups was = 35 months). Among participants without virological failure = 6 months after the start of cART, CD4 cell counts continued to increase up to 8 years, with little evidence that differences between baseline CD4 cell count groups diminished over time. Virological failure = 6 months after the start of cART was associated with lower subsequent CD4 cell counts, with greater CD4 cell count reduction for more recent virological failure and higher viral load. CONCLUSIONS Post-cART CD4 cell counts are strongly related to pre-cART CD4 cell counts. CD4 cell count recovery is greatest in individuals who can avoid viral loads >1000 copies/mL while on cART.

History

Publication status

  • Published

Journal

HIV Medicine

ISSN

1464-2662

Publisher

WIley

Issue

10

Volume

12

Page range

583-593

Department affiliated with

  • BSMS Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2014-02-14

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