title: CD4 cell eligibility thresholds: an analysis of the time to antiretroviral treatment in HIV-1 seroconverters.
abstract: BACKGROUND
  WHO recommends initiating combination antiretroviral treatment at the minimal CD4 cell threshold of 350 cells/μl. In sub-Saharan Africa, the time for a recently infected patient to reach this threshold is unclear.
  
  
  METHODS
  We estimated the probability of reaching different CD4 cell thresholds over time in the ANRS 1220 cohort of HIV-1 seroconverters in Côte d'Ivoire. CD4 cell slopes were estimated using a mixed linear model. Probabilities of crossing the 350 and 500 cells/μl CD4 cell thresholds were estimated by the Kaplan-Meier method.
  
  
  RESULTS
  Between 1997 and 2009, 304 recent seroconverters have been enrolled in the Primo-CI cohort (62% men, median baseline age 29 years and median time since the estimated date of seroconversion 9 months). The probability of having a first CD4 cell count below 500 cells/μl was 0.57, 0.72, 0.79 and 0.84 at study entry, 2, 4 and 6 years, respectively. For a first CD4 cell count below 350 cells/μl, these figures were 0.29, 0.40, 0.55 and 0.67. The time for 75% of patients to reach the threshold was 3.0 years for 500 cells/μl and 7.0 years for 350 cells/μl.
authors.affiliation: Programme PAC-CI, Abidjan, Côte d'Ivoire, France. minga.albert@yahoo.fr
authors.forename: Albert K
authors.initials: AK
authors.lastname: Minga
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lewden
authors.forename: Delphine
authors.initials: D
authors.lastname: Gabillard
authors.forename: Germain I
authors.initials: GI
authors.lastname: Bomisso
authors.forename: Thomas-d'aquin
authors.initials: TD
authors.lastname: Toni
authors.forename: Arlette A
authors.initials: AA
authors.lastname: Emième
authors.forename: Vincent
authors.initials: V
authors.lastname: Yapo
authors.forename: André
authors.initials: A
authors.lastname: Inwoley
authors.forename: Roger
authors.initials: R
authors.lastname: Salamon
authors.forename: Xavier
authors.initials: X
authors.lastname: Anglaret
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D006679:HIV Seropositivity / Q000175:diagnosis / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents