Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: Results from The TREAT Asia HIV Observational Database

Jialun Zhou, Thira Sirisanthana, Sasisopin Kiertiburanakul, Yi Ming A. Chen, Ning Han, Poh Lian Lim, Nagalingeswaran Kumarasamy, Jun Y. Choi, Tuti P. Merati, Evy Yunihastuti, Shinichi Oka, Adeeba Kamarulzaman, Praphan Phanuphak, Christopher K.C. Lee, Patrick C.K. Li, Sanjay Pujari, Vanthanak Saphonn, Matthew G. Law

Research output: Contribution to journalArticle

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Abstract

Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.

Original languageEnglish
Article number361
JournalBMC Infectious Diseases
Volume10
DOIs
Publication statusPublished - Dec 23 2010
Externally publishedYes

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CD4 Lymphocyte Count
Viral Load
HIV
Databases
Therapeutics
Linear Models
Hepatitis C
Hepatitis B
Coinfection
Drug Resistance

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment : Results from The TREAT Asia HIV Observational Database. / Zhou, Jialun; Sirisanthana, Thira; Kiertiburanakul, Sasisopin; Chen, Yi Ming A.; Han, Ning; Lim, Poh Lian; Kumarasamy, Nagalingeswaran; Choi, Jun Y.; Merati, Tuti P.; Yunihastuti, Evy; Oka, Shinichi; Kamarulzaman, Adeeba; Phanuphak, Praphan; Lee, Christopher K.C.; Li, Patrick C.K.; Pujari, Sanjay; Saphonn, Vanthanak; Law, Matthew G.

In: BMC Infectious Diseases, Vol. 10, 361, 23.12.2010.

Research output: Contribution to journalArticle

Zhou, J, Sirisanthana, T, Kiertiburanakul, S, Chen, YMA, Han, N, Lim, PL, Kumarasamy, N, Choi, JY, Merati, TP, Yunihastuti, E, Oka, S, Kamarulzaman, A, Phanuphak, P, Lee, CKC, Li, PCK, Pujari, S, Saphonn, V & Law, MG 2010, 'Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: Results from The TREAT Asia HIV Observational Database', BMC Infectious Diseases, vol. 10, 361. https://doi.org/10.1186/1471-2334-10-361
Zhou, Jialun ; Sirisanthana, Thira ; Kiertiburanakul, Sasisopin ; Chen, Yi Ming A. ; Han, Ning ; Lim, Poh Lian ; Kumarasamy, Nagalingeswaran ; Choi, Jun Y. ; Merati, Tuti P. ; Yunihastuti, Evy ; Oka, Shinichi ; Kamarulzaman, Adeeba ; Phanuphak, Praphan ; Lee, Christopher K.C. ; Li, Patrick C.K. ; Pujari, Sanjay ; Saphonn, Vanthanak ; Law, Matthew G. / Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment : Results from The TREAT Asia HIV Observational Database. In: BMC Infectious Diseases. 2010 ; Vol. 10.
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abstract = "Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74{\%} male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.",
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T1 - Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment

T2 - Results from The TREAT Asia HIV Observational Database

AU - Zhou, Jialun

AU - Sirisanthana, Thira

AU - Kiertiburanakul, Sasisopin

AU - Chen, Yi Ming A.

AU - Han, Ning

AU - Lim, Poh Lian

AU - Kumarasamy, Nagalingeswaran

AU - Choi, Jun Y.

AU - Merati, Tuti P.

AU - Yunihastuti, Evy

AU - Oka, Shinichi

AU - Kamarulzaman, Adeeba

AU - Phanuphak, Praphan

AU - Lee, Christopher K.C.

AU - Li, Patrick C.K.

AU - Pujari, Sanjay

AU - Saphonn, Vanthanak

AU - Law, Matthew G.

PY - 2010/12/23

Y1 - 2010/12/23

N2 - Background: The aim of this study was to examine the relationship between trends in CD4 counts (slope) and HIV viral load (VL) after initiation of combination antiretroviral treatment (cART) in Asian patients in The TREAT Asia HIV Observational Database (TAHOD).Methods: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.Results: A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.Conclusions: After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.

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