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Factors associated with short-term changes in HIV viral load and CD4 R cell count in antiretroviral-naive individuals

Nakagawa, F; Grp, NHPW; Ep, COHIV; EuroCoord; (2014) Factors associated with short-term changes in HIV viral load and CD4 R cell count in antiretroviral-naive individuals. AIDS , 28 (9) 1351 - 1356. 10.1097/QAD.0000000000000224. Green open access

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Abstract

Objectives: Among antiretroviral therapy (ART)-naive individuals, viral load levels tend to increase and CD4þ cell counts decline over time. We sought to explore the rate of change and influence of other factors associated with these markers of HIV progression. Design: An observational cohort collaboration study. Methods: A total of 158 385 pairs of consecutive viral load and CD4þ cell count simultaneously measured from 34 384 ART-naive individuals in the COHERE database were analysed. Annual changes and factors associated with these changes were estimated using generalized estimating equations. Results: Viral load continued to rise at a mean [95% confidence interval (CI)] rate of 0.091 (0.086–0.096) log10 copies/ml per year. A faster rise in viral load was significantly associated with older age, such that for every 10 years older, it was a mean 0.022 log10 copies/ml per year greater. The mean (95% CI) CD4þ cell count change was �78.0 (�80.1 to �76.0) cell/ml per year and it was strongly associated with a higher current viral load: for every 1 log10 copies/ml higher, CD4þ cell count declined by an additional 37.6 cells/ml per year (P<0.001). Current viral load was a stronger predictor of CD4þ cell count depletion than baseline viral load. Neither sex, race nor transmission by injecting drug use was associated with change in either the viral load or CD4þ cell count. Discussion: We found that in ART-naive individuals, viral load continues to increase over time and more sharply in those who are older. Our results also suggest that higher current viral load is strongly associated with ongoing rate of CD4þ cell count depletion.

Type: Article
Title: Factors associated with short-term changes in HIV viral load and CD4 R cell count in antiretroviral-naive individuals
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000000224
Publisher version: http://dx.doi.org/10.1097/QAD.0000000000000224
Additional information: © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
Keywords: antiretroviral-naive, CD4(+) lymphocyte count, HIV, HIV viral load
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 > 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 > 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/1433365
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