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Title: Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy
Authors: Nam Su Ku
Awachana Jiamsakul
Oon Tek Ng
Evy Yunihastuti
Do Duy Cuong
Man Po Lee
Benedict Lim Heng Sim
Praphan Phanuphak
Wing Wai Wong
Adeeba Kamarulzaman
Fujie Zhang
Sanjay Pujari
Romanee Chaiwarith
Shinichi Oka
Mahiran Mustafa
Nagalingeswaran Kumarasamy
Kinh Van Nguyen
Rossana Ditangco
Sasisopin Kiertiburanakul
Tuti Parwati Merati
Nicolas Durier
Jun Yong Choi
Yonsei University College of Medicine
University of New South Wales (UNSW) Australia
Tan Tock Seng Hospital
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Bach Mai Hospital
Queen Elizabeth Hospital Hong Kong
Hospital Sungai Buloh
The HIV Netherlands Australia Thailand Research Collaboration
Veterans General Hospital-Taipei
University of Malaya Medical Centre
Beijing Ditan Hospital
Institute of Infectious Diseases
Chiang Mai University
National Center for Global Health and Medicine
Hospital Raja Perempuan Zainab II
VHS Medical Centre India
National Hospital for Tropical Diseases
Mahidol University
Universitas Udayana
amfAR - The Foundation for AIDS Research
Keywords: Medicine
Issue Date: 1-Aug-2016
Citation: Medicine (United States). Vol.95, No.32 (2016)
Abstract: Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort. We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ≥400 copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ≥1200 cells/μL. Time to VF was modeled using Cox regression analysis, stratified by site. In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27%) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR = 1.35, 95% CI 1.14-1.61; P = 0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P = 0.420). This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART.
ISSN: 15365964
Appears in Collections:Scopus 2016-2017

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