Universität zu Köln

Hughes, Rachael A., May, Margaret T., Tilling, Kate, Taylor, Ninon, Wittkop, Linda ORCID: 0000-0003-2403-0960, Reiss, Peter, Gill, John, Schommers, Philipp ORCID: 0000-0003-3375-6800, Costagliola, Dominique ORCID: 0000-0003-0765-0869, Guest, Jodie L., Lima, Viviane D., Monforte, Antonella d'Arminio, Smith, Colette ORCID: 0000-0003-2847-3355, Cavassini, Matthias, Saag, Michael, Castilho, Jessica L. and Sterne, Jonathan A. C. (2018). Long terms trends in CD4(+) cell counts, CD8(+) cell counts, and the CD4(+):CD8(+) ratio. Aids, 32 (10). S. 1361 - 1368. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Objective: Model trajectories of CD4(+) and CD8(+) cell counts after starting combination antiretroviral therapy (ART) and use the model to predict trends in these counts and the CD4(+):CD8(+) ratio. Design: Cohort study of antiretroviral-naive HIV-positive adults who started ART after 1997 (ART Cohort Collaboration) with more than 6 months of follow-up data. Methods: We jointly estimated CD4(+) and CD8(+) cell count trends and their correlation using a bivariate random effects model, with linear splines describing their population trends, and predicted the CD4(+):CD8(+) ratio trend from this model. We assessed whether CD4(+) and CD8(+) cell count trends and the CD4(+):CD8(+) ratio trend varied according to CD4(+) cell count at start of ART (baseline), and, whether these trends differed in patients with and without virological failure more than 6 months after starting ART. Results: A total of 39979 patients were included (median follow-up was 53 months). Among patients with baseline CD4(+) cell count at least 50 cells/l, predicted mean CD8(+) cell counts continued to decrease between 3 and 15 years post-ART, partly driving increases in the predicted mean CD4(+):CD8(+) ratio. During 15 years of follow-up, normalization of the predicted mean CD4(+):CD8(+) ratio (to >1) was only observed among patients with baseline CD4(+) cell count at least 200 cells/l. A higher baseline CD4(+) cell count predicted a shorter time to normalization. Conclusion: Declines in CD8(+) cell count and increases in CD4(+):CD8(+) ratio occurred up to 15 years after starting ART. The likelihood of normalization of the CD4(+):CD8(+) ratio is strongly related to baseline CD4(+) cell count. Copyright (C) 2018 The Author(s). Published by Wolters Kluwer Health, Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hughes, Rachael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED May, Margaret T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tilling, Kate UNSPECIFIED UNSPECIFIED UNSPECIFIED Taylor, Ninon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittkop, Linda UNSPECIFIED orcid.org/0000-0003-2403-0960 UNSPECIFIED Reiss, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Gill, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Schommers, Philipp UNSPECIFIED orcid.org/0000-0003-3375-6800 UNSPECIFIED Costagliola, Dominique UNSPECIFIED orcid.org/0000-0003-0765-0869 UNSPECIFIED Guest, Jodie L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lima, Viviane D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Monforte, Antonella d'Arminio UNSPECIFIED UNSPECIFIED UNSPECIFIED Smith, Colette UNSPECIFIED orcid.org/0000-0003-2847-3355 UNSPECIFIED Cavassini, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Saag, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Castilho, Jessica L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterne, Jonathan A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-182721
DOI:	10.1097/QAD.0000000000001848
Journal or Publication Title:	Aids
Volume:	32
Number:	10
Page Range:	S. 1361 - 1368
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ANTIRETROVIRAL THERAPY; HIV-INFECTION; LARGE COHORT; VIRAL LOAD; NORMALIZATION; INFLAMMATION; IMMUNODEFICIENCY; SUPPRESSION; MARKER; OLD Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18272