Publication: Factors associated with immunological discordance in HIV-infected patients receiving antiretroviral therapy with complete viral suppression in a resource-limited setting
Issued Date
2015-01-01
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ISSN
18842836
13446304
13446304
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2-s2.0-84937437569
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Mahidol University
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SCOPUS
Bibliographic Citation
Japanese Journal of Infectious Diseases. Vol.68, No.4 (2015), 301-304
Suggested Citation
Pornpimol Mingbunjerdsuk, Nakhon Asdamongkol, Somnuek Sungkanuparph Factors associated with immunological discordance in HIV-infected patients receiving antiretroviral therapy with complete viral suppression in a resource-limited setting. Japanese Journal of Infectious Diseases. Vol.68, No.4 (2015), 301-304. doi:10.7883/yoken.JJID.2014.062 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/36591
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Title
Factors associated with immunological discordance in HIV-infected patients receiving antiretroviral therapy with complete viral suppression in a resource-limited setting
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Abstract
© 2015, National Institute of Health. All rights reserved. “Immunological discordance,” i.e., immunological failure despite complete viral suppression in human immunodeficiency virus (HIV)-infected patients receiving antiretroviral therapy (ART), is associated with increased risk of AIDS or death. To evaluate risk factors for immunological discordance in a resource-limited setting in which patients usually present late with low CD4 cell counts, we conducted a case-control study among HIV-infected patients receiving ART and having undetectable HIV RNA. The study included patients with immunological discordance (cases), which was defined as CD4 cell count ＜ 30z above baseline and absolute CD4 cell count ＜ 200 cells/mm<sup>3</sup> at the first 12 months of undetectable HIV RNA (＜50 copies/mL). Patients without immunological discordance were included as controls. Of 142 patients (44 cases; 98 controls), the mean age was 38.6 ± 9.4 years and 67.6z were men; 65.5z had history of opportunistic infections. In multivariate analysis, only baseline CD4 cell count ＜ 100 cells/mm<sup>3</sup> (odd ratio [OR], 2.53; 95z confidence interval [CI], 1.04–6.14; P ＝ 0.040) and history of lost to follow-up (OR, 11.04; 95z CI, 2.87–42.46; P ＜ 0.001) were significantly associated with immunological discordance. Early initiation of ART and intervention to improve regular clinic visit compliance and adherence to ART are crucial to prevent immunological discordance among HIV-infected patients.