title: Magnitude and determinants of CD4 recovery after HAART resumption after 1 cycle of treatment interruption.
abstract: OBJECTIVE
  The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.
  
  
  METHODS
  Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/microL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.
  
  
  RESULTS
  One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/microL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/microL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads < 5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.
  
  
  CONCLUSIONS
  Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.
authors: Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy. crimuss@unimo.it
authors: Cristina
authors: C
authors: Mussini
authors: Giota
authors: G
authors: Touloumi
authors: Giorgos
authors: G
authors: Bakoyannis
authors: Caroline
authors: C
authors: Sabin
authors: Antonella
authors: A
authors: Castagna
authors: Laura
authors: L
authors: Sighinolfi
authors: Lars E
authors: LE
authors: Erikson
authors: Goran
authors: G
authors: Bratt
authors: Vanni
authors: V
authors: Borghi
authors: Adriano
authors: A
authors: Lazzarin
authors: Andrea
authors: A
authors: Cossarizza
authors: Roberto
authors: R
authors: Esposito
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016312:Treatment Refusal
chemical_list: D019380:Anti-HIV Agents