Publication: Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: Results from The TREAT Asia HIV Observational Database
Issued Date
2010-12-23
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14712334
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2-s2.0-78651492845
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Infectious Diseases. Vol.10, (2010)
Suggested Citation
Jialun Zhou, Thira Sirisanthana, Sasisopin Kiertiburanakul, Yi Ming A. Chen, Ning Han, Poh Lian Lim, Nagalingeswaran Kumarasamy, Jun Y. Choi, Tuti P. Merati, Evy Yunihastuti, Shinichi Oka, Adeeba Kamarulzaman, Praphan Phanuphak, Christopher K.C. Lee, Patrick C.K. Li, Sanjay Pujari, Vanthanak Saphonn, Matthew G. Law Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: Results from The TREAT Asia HIV Observational Database. BMC Infectious Diseases. Vol.10, (2010). doi:10.1186/1471-2334-10-361 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/29339
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Title
Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: Results from The TREAT Asia HIV Observational Database
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Other Contributor(s)
Kirby Institute
Chiang Mai University
Mahidol University
National Yang-Ming University Taiwan
Beijing Ditan Hospital
Tan Tock Seng Hospital
YR Gaitonde Centre for AIDS Research and Education
Yonsei University College of Medicine
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
National Center for Global Health and Medicine
University of Malaya Medical Centre
The HIV Netherlands Australia Thailand Research Collaboration
Hospital Sungai Buloh
Queen Elizabeth Hospital Hong Kong
Institute of Infectious Diseases
National Center for HIV/AIDS
Chiang Mai University
Mahidol University
National Yang-Ming University Taiwan
Beijing Ditan Hospital
Tan Tock Seng Hospital
YR Gaitonde Centre for AIDS Research and Education
Yonsei University College of Medicine
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
National Center for Global Health and Medicine
University of Malaya Medical Centre
The HIV Netherlands Australia Thailand Research Collaboration
Hospital Sungai Buloh
Queen Elizabeth Hospital Hong Kong
Institute of Infectious Diseases
National Center for HIV/AIDS
Abstract
Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain. © 2010 Zhou et al; licensee BioMed Central Ltd.