title: Dynamic Visual Display of Treatment Response in HIV-Infected Adults.
abstract: BACKGROUND
  Using a dynamic visual display, we examine the changes in human immunodeficiency virus type 1 (HIV-1) plasma viral load and CD4 cell count for 5 years after antiretroviral therapy initiation in a large cohort of patients with HIV.
  
  
  METHODS
  Patients at a Centers for AIDS Research Network of Integrated Clinical Systems site who initiated combination antiretroviral therapy between 1 January 2000 and 31 December 2012 were followed for 5 years for HIV-1 plasma viral load, CD4 cell count, and mortality. The joint distribution of CD4 cell count and viral load over time was depicted in an animated display using a bivariate kernel smoother.
  
  
  RESULTS
  Within days of therapy initiation, many patients had a suppressed viral load and their median CD4 cell count had increased. However, the median CD4 cell count remained below normal levels throughout follow-up period and the proportion of patients with high viral load occasionally increased, even years after therapy initiation.
  
  
  CONCLUSIONS
  The dramatic changes in viral load and CD4 cell count after therapy initiation highlight the overwhelming effectiveness of antiretroviral therapy in the modern era. However, this work also emphasizes the need for pharmaceutical or behavioral interventions to prevent virologic failure and to stimulate complete recovery of normal CD4 cell count.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill.
authors.forename: Jessie K
authors.initials: JK
authors.lastname: Edwards
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.affiliation: School of Medicine, University of California, San Francisco.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Martin
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.affiliation: School of Medicine, University of California, San Diego.
authors.forename: W Christopher
authors.initials: WC
authors.lastname: Mathews
authors.affiliation: School of Medicine, University of Washington, Seattle.
authors.forename: Mari
authors.initials: M
authors.lastname: Kitahata
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Eron
authors.affiliation: School of Medicine, University of Alabama, Birmingham.
authors.forename: Michael
authors.initials: M
authors.lastname: Saag
authors.affiliation: School of Medicine, University of Alabama, Birmingham.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D010949:Plasma / Q000821:virology*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: HIV/AIDS; antiretroviral therapy
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