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The potential for CD4 cell increases in HIV-positive individuals who control viraemia with highly active antiretroviral therapy
被引:69
作者:
Smith, CJ
Sabin, CA
Lampe, FC
Kinloch-de-Loes, S
Gumley, H
Carroll, A
Prinz, B
Youle, M
Johnson, MA
Phillips, AN
机构:
[1] UCL Royal Free & Univ Coll Med Sch, Dept Primary Care & Populat Sci, London NW3 2PF, England
[2] UCL Royal Free & Univ Coll Med Sch, Royal Free Ctr HIV Med, London NW3 2PF, England
[3] UCL Royal Free & Univ Coll Med Sch, Dept Immunol & Mol Pathol, London NW3 2PF, England
[4] UCL Royal Free & Univ Coll Med Sch, Dept Thorac Med, London NW3 2PF, England
来源:
关键词:
CD4 cell count;
epidemiology;
highly active antiretrorival therapy;
immune reconstitution;
virological suppression;
D O I:
10.1097/00002030-200305020-00004
中图分类号:
R392 [医学免疫学];
Q939.91 [免疫学];
学科分类号:
100102 ;
摘要:
Objectives: To study the long-term CD4 cell responses to highly active antiretroviral therapy (HAART) in treatment-naive patients whose viral loads remained below 500 copies/ml for prolonged periods. Design: A total of 237 patients whose viral loads remained below 500 copies/ml for one year or more. Median follow-up was 1.9 years. Methods: CD4 cell counts were analysed to investigate long-term immunological response using mixed-effects models with the slope allowed to change after 1, 12 and 24 months of HAART. Results: The median baseline CD4 cell count was 175 cells/mm(3). After an initial rapid increase in the first month after HAART (97.2 cells/mm(3) a month), increases in CD4 cell counts continued less rapidly (11.6 cells/mm(3) a month). This increase slowed by 2.4 cells/mm(3) a month after one year. CD4 cell counts continued increasing after 2 years, but the rate of increase again slowed (estimated slope at 2 years 5.4 cells/mm(3) a month; decrease in slope from year 2 compared with years 1-2 3.7 cell/mm(3) a month). A total of 198 out of 211 patients (94%) with measurements at baseline and one year experienced an increase in CD4 cell counts in this interval; 81 and 67% had an increasing slope between 1 and 2 and 2 and 3 years, respectively. By the end of follow-up, CD4 cell counts had increased by 319 cells/mm(3), and were more than 500 cells/mm(3) in 40% of patients. Conclusion: Although the rate of immune recovery slowed after 2 years, CD4 cell counts rose in most and began to return to levels seen in HIV-negative individuals. (C) 2003 Lippincott Williams Wilkins.
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页码:963 / 969
页数:7
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