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Evolution of CD4 T-Cell count with age in a cohort of young people growing up with perinatally acquired HIV

Castro, Hannah; Sabin, Caroline; Collins, Intira Jeannie; Okhai, Hajra; Schou Sandgaard, Katrine; Prime, Katia; Foster, Caroline; ... UK Collaborative HIV Cohort (UK CHIC), .; + view all (2023) Evolution of CD4 T-Cell count with age in a cohort of young people growing up with perinatally acquired HIV. Clinical Infectious Diseases , Article ciad626. 10.1093/cid/ciad626. (In press). Green open access

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Abstract

Background: Recent studies have shown a decrease in CD4 count during adolescence in young people with perinatally acquired HIV (PHIV). We examine changes and predictors of CD4 over time in PHIV in the UK and compare to published CD4 data in the general population.// Methods: PHIV followed in the Collaborative HIV Paediatric Study who started antiretroviral therapy (ART) from 2000 onwards were included. Follow-up data from the UK Collaborative HIV Cohort Study were also used. Changes in CD4 count over time from age 10 to 20 years were analysed using mixed effects models. Potential predictors included demographics, age at ART start, nadir CD4 z-score (age-adjusted) in childhood and time-updated viral load.// Results: Of 1,258 PHIV included, 669 (53%) were female, median [IQR] age at ART initiation was 8.3 years [3.5, 12.1] and nadir CD4 z-score was -4.0 [-5.9, -2.5]. In multivariable analysis, mean CD4 count was higher in PHIV who started ART before age 10 and had a nadir CD4 z-score ≥-4 in childhood; these PHIV had a decline in CD4 count after age 10 which was comparable to the general population. Mean CD4 count was lower in PHIV who had started ART before age 10 and had a nadir CD4 z-score <-4 in childhood; for this group the decline in CD4 count after age 10 was steeper over time.// Conclusions: In children, as well as starting ART at an early age, optimising ART to maintain a higher CD4 z-score during childhood may be important to maximize immune reconstitution later in life.

Type: Article
Title: Evolution of CD4 T-Cell count with age in a cohort of young people growing up with perinatally acquired HIV
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/cid/ciad626
Publisher version: https://doi.org/10.1093/cid/ciad626
Language: English
Additional information: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: CD4 T-Cell, HIV, UK, adult, child, perinatal
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 > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10178997
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