Long terms trends in CD4+ cell counts, CD8+ cell counts, and the CD4+ :  CD8+ ratio.

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License: CC BY 4.0
Serval ID
serval:BIB_B55B1D655205
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long terms trends in CD4+ cell counts, CD8+ cell counts, and the CD4+ :  CD8+ ratio.
Journal
AIDS
Author(s)
Hughes R.A., May M.T., Tilling K., Taylor N., Wittkop L., Reiss P., Gill J., Schommers P., Costagliola D., Guest J.L., Lima V.D., d'Arminio Monforte A., Smith C., Cavassini M., Saag M., Castilho J.L., Sterne JAC
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Publication state
Published
Issued date
19/06/2018
Peer-reviewed
Oui
Volume
32
Number
10
Pages
1361-1367
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Model trajectories of CD4+ and CD8+ cell counts after starting combination antiretroviral therapy (ART) and use the model to predict trends in these counts and the CD4+ : CD8+ ratio.
Cohort study of antiretroviral-naïve HIV-positive adults who started ART after 1997 (ART Cohort Collaboration) with more than 6 months of follow-up data.
We jointly estimated CD4+ and CD8+ cell count trends and their correlation using a bivariate random effects model, with linear splines describing their population trends, and predicted the CD4+ : CD8+ ratio trend from this model. We assessed whether CD4+ and CD8+ cell count trends and the CD4+ : CD8+ ratio trend varied according to CD4+ cell count at start of ART (baseline), and, whether these trends differed in patients with and without virological failure more than 6 months after starting ART.
A total of 39 979 patients were included (median follow-up was 53 months). Among patients with baseline CD4+ cell count at least 50 cells/μl, predicted mean CD8+ cell counts continued to decrease between 3 and 15 years post-ART, partly driving increases in the predicted mean CD4+ : CD8+ ratio. During 15 years of follow-up, normalization of the predicted mean CD4+ : CD8+ ratio (to >1) was only observed among patients with baseline CD4+ cell count at least 200 cells/μl. A higher baseline CD4+ cell count predicted a shorter time to normalization.
Declines in CD8+ cell count and increases in CD4+ : CD8+ ratio occurred up to 15 years after starting ART. The likelihood of normalization of the CD4+ : CD8+ ratio is strongly related to baseline CD4+ cell count.
Keywords
Adolescent, Adult, Anti-Retroviral Agents/therapeutic use, CD4 Lymphocyte Count, CD4-CD8 Ratio, CD4-Positive T-Lymphocytes/immunology, CD8-Positive T-Lymphocytes/immunology, Cohort Studies, Female, Follow-Up Studies, HIV Infections/drug therapy, HIV Infections/pathology, HIV Infections/virology, Humans, Male, Middle Aged, Models, Statistical, Viral Load
Pubmed
Web of science
Create date
15/06/2018 17:12
Last modification date
24/09/2019 5:11
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