Gianotti, N;
Marchetti, G;
Antinori, A;
Saracino, A;
Gori, A;
Rizzardini, G;
Lichtner, M;
... Cozzi-Lepri, A; + view all
(2017)
Drop in CD4(+) Counts Below 200 Cells/mu L After Reaching (or Starting From) Values Higher than 350 Cells/mu L in HIV-Infected Patients With Virological Suppression.
JAIDS: Journal of Acquired Immune Deficiency Syndromes
, 76
(4)
pp. 417-422.
10.1097/QAI.0000000000001522.
Preview |
Text
Cozzi-Lepri_gianotti paper drop-200 JAIDS%23reviewed.pdf - Accepted Version Download (382kB) | Preview |
Abstract
BACKGROUND: The aim of the study was to quantify the risk of a drop in CD4+ counts below 200 cells/μL after reaching values >350 cells/μL on antiretroviral therapy (ART) (or after starting ART with CD4+ count >350 cells/μL) in the absence of virological failure. SETTING: Ambulatory care services, Italy. METHODS: Prospective cohort study of patients enrolled in the ICONA Foundation Study cohort who started ART with >350 CD4+/μL or with ≤350 CD4+/μL and reached values >350 cells/μL after virological suppression (VS, defined by 2 consecutive viral loads ≤50 copies/mL). The date of CD4 count >350 was the baseline for the analysis and those with ≥1 viral load and CD4+ count after baseline were included. The primary end point was the cumulative risk (estimated using the Kaplan–Meier method) of a CD4+ drop below 200 cells/μL over follow-up, which was censored at the date of virological failure (confirmed HIV-RNA >50 copies/mL), death, or last visit. RESULTS: Six thousand six hundred sixty-three patients were included. A confirmed CD4+ drop below 200 cells/μL was never observed over a median follow-up of 45 (Q1: 21, Q3: 89) months, as long as VS was maintained. Upper limits of the 97.5% confidence interval of rates of confirmed CD4+ drop below 200 cells/μL were 0.28 and 0.38/1000 person-years of follow-up for patients with ≤350 and >350 CD4+ cells/μL at starting ART. CONCLUSIONS: In patients who started ART in Italy with >350 CD4+ cells/μL or reached >350 CD4+ cells/μL after VS, the risk of a CD4+ drop below 200 cells/μL in those maintaining VS was negligible.
| Type: | Article |
|---|---|
| Title: | Drop in CD4(+) Counts Below 200 Cells/mu L After Reaching (or Starting From) Values Higher than 350 Cells/mu L in HIV-Infected Patients With Virological Suppression |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAI.0000000000001522 |
| Publisher version: | http://dx.doi.org/10.1097/QAI.0000000000001522 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, CD4(+) cells count, CD4(+) count dipping, CD4(+) count monitoring, virological suppression, antiretroviral therapy, antiretroviral therapy, observational cohort, mortality, individuals, guidelines, safe |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10044430 |
Archive Staff Only
 |
View Item |
