Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal.
To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm3 (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was approximately 421 cells/mm3 (95% CI = 390; 454) in patients with < 200 cells/mm3 at baseline and approximately 500 cells/mm3 in patients with > 200 cells/mm3. The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm3 at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment.
De Beaudrap
Pierre
P
Hospices Civils de Lyon, Service de Biostatistique, Lyon, F-69003, France. pierre.debeaudrap@ird.fr
Etard
Jean-François
JF
Diouf
Assane
A
Ndiaye
Ibrahima
I
Guèye
Ndèye Fatou
NF
Guèye
Pape Mandoumbé
PM
Sow
Papa Salif
PS
Mboup
Souleymane
S
Ndoye
Ibra
I
Ecochard
René
R
Eric
Delaporte
D
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D016014:Linear Models; D008297:Male; D008954:Models, Biological; D012675:Senegal / Q000453:epidemiology
D019380:Anti-HIV Agents