title: Three different patterns of CD4 recovery in a cohort of Chinese HIV patients following antiretroviral therapy - a five-year observational study.
abstract: To explore the heterogeneity of CD4 responses following highly active antiretroviral therapy, the patterns of CD4 recovery of HIV-1-infected Chinese patients who have been on their first antiretroviral regimen for ≥5 years were analysed. The CD4 trajectories were traced, smoothed and differentiated into three defined profiles. Half (56.3%) were 'satisfactory responders', with CD4 gain of >100 cells/μL and a peak of >350 cells/μL, plateauing before the end of Year 5. Thirty-three (24.4%) were 'continuing responders' whose CD4 rise persisted at Year 4-5. The remaining 26 (19.3%) were 'poor responders'. Presentation with AIDS before therapy was common not just among 'poor' but also paradoxically the 'continuing' responders. While a majority had responded well to antiretroviral therapy, older patients and those with AIDS diagnosis before initiation of therapy may never achieve a satisfactory level even with effective treatment. Categorization of HIV patients by their CD4 trajectory may support the prediction of immunological outcome over time, and ultimately inform treatment choices.
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Naftalin
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Ngai Sze
authors.initials: NS
authors.lastname: Wong
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Denise P C
authors.initials: DP
authors.lastname: Chan
authors.affiliation: Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region Government, Hong Kong, People's Republic of China.
authors.forename: Ka Hing
authors.initials: KH
authors.lastname: Wong
authors.affiliation: Global Public Health, School of Medicine and Health Sciences, Monash University, Kuala Lumpur, Malaysia.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Reidpath
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China sslee@cuhk.edu.hk.
authors.forename: Shui Shan
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D044466:Asian People / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D012367:RNA, Viral
keywords: AIDS; Asia; CD4 count; HAART; HIV; antiretroviral therapy; immunological response; treatment