title: Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy.
abstract: BACKGROUND
  The relationship between CD4 T-cell counts determined soon after seroconversion with HIV-1 (baseline CD4), nadir CD4, and CD4 levels attained during highly active antiretroviral therapy (HAART) is unknown.
  
  
  METHODS
  Longitudinal, including baseline (at or soon after HIV diagnosis), intermediate (nadir), and distal (post-HAART) CD4 T-cell counts were assessed in 1085 seroconverting subjects who achieved viral load suppression from a large well-characterized cohort. The association of baseline with post-HAART CD4 T-cell count was determined after adjustment for other relevant covariates.
  
  
  RESULTS
  A higher baseline CD4 T-cell count predicted a greater post-HAART CD4 T-cell count, independent of the nadir and other explanatory variables. Together, baseline and nadir strongly predicted the post-HAART CD4 count such that a high baseline and lower nadir were associated with a maximal immune recovery after HAART. Likelihood of recovery of the baseline count after HAART was significantly higher when the nadir/baseline count ratio was consistently ≥ 0.6.
  
  
  CONCLUSIONS
  Among viral load suppressing seroconverters, the absolute CD4 T-cell count attained post-HAART is highly dependent on both baseline and nadir CD4 T-cell counts. These associations further support the early diagnosis and initiation of HAART among HIV-infected persons.
authors.affiliation: Veterans Administration Research Center for AIDS and HIV-1 Infection, South Texas Veterans Health Care System, San Antonio, TX, USA.
authors.forename: Hemant
authors.initials: H
authors.lastname: Kulkarni
authors.forename: Jason F
authors.initials: JF
authors.lastname: Okulicz
authors.forename: Greg
authors.initials: G
authors.lastname: Grandits
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: Michael L
authors.initials: ML
authors.lastname: Landrum
authors.forename: Braden
authors.initials: B
authors.lastname: Hale
authors.forename: Glenn
authors.initials: G
authors.lastname: Wortmann
authors.forename: Edmund
authors.initials: E
authors.lastname: Tramont
authors.forename: Michael
authors.initials: M
authors.lastname: Polis
authors.forename: Matthew
authors.initials: M
authors.lastname: Dolan
authors.forename: Alan R
authors.initials: AR
authors.lastname: Lifson
authors.forename: Brian K
authors.initials: BK
authors.lastname: Agan
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Ahuja
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Marconi
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1; D006801:Humans; D011237:Predictive Value of Tests; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents