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Title

CD4+ T cell count recovery in HIV type 1-infected patients is independent of class of antiretroviral therapy

Authors
Khanna, Nina
Opravil, Milos
Furrer, Hansjakob
Cavassini, Matthias
Vernazza, Pietro
Weber, Rainer
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Published in Clinical Infectious Diseases. 2008, vol. 47, no. 8, p. 1093-101
Abstract BACKGROUND: In recent years, treatment options for human immunodeficiency virus type 1 (HIV-1) infection have changed from nonboosted protease inhibitors (PIs) to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) and boosted PI-based antiretroviral drug regimens, but the impact on immunological recovery remains uncertain. METHODS: During January 1996 through December 2004 [corrected] all patients in the Swiss HIV Cohort were included if they received the first combination antiretroviral therapy (cART) and had known baseline CD4(+) T cell counts and HIV-1 RNA values (n = 3293). For follow-up, we used the Swiss HIV Cohort Study database update of May 2007 [corrected] The mean (+/-SD) duration of follow-up was 26.8 +/- 20.5 months. The follow-up time was limited to the duration of the first cART. CD4(+) T cell recovery was analyzed in 3 different treatment groups: nonboosted PI, NNRTI, or boosted PI. The end point was the absolute increase of CD4(+) T cell count in the 3 treatment groups after the initiation of cART. RESULTS: Two thousand five hundred ninety individuals (78.7%) initiated a nonboosted-PI regimen, 452 (13.7%) initiated an NNRTI regimen, and 251 (7.6%) initiated a boosted-PI regimen. Absolute CD4(+) T cell count increases at 48 months were as follows: in the nonboosted-PI group, from 210 to 520 cells/muL; in the NNRTI group, from 220 to 475 cells/muL; and in the boosted-PI group, from 168 to 511 cells/muL. In a multivariate analysis, the treatment group did not affect the response of CD4(+) T cells; however, increased age, pretreatment with nucleoside reverse-transcriptase inhibitors, serological tests positive for hepatitis C virus, Centers for Disease Control and Prevention stage C infection, lower baseline CD4(+) T cell count, and lower baseline HIV-1 RNA level were risk factors for smaller increases in CD4(+) T cell count. CONCLUSION: CD4(+) T cell recovery was similar in patients receiving nonboosted PI-, NNRTI-, and boosted PI-based cART.
Keywords AdultAnti-HIV Agents/therapeutic useCD4 Lymphocyte CountCohort StudiesFemaleHIV Infections/drug therapy/immunology/virologyHIV-1/isolation & purificationHumansLongitudinal StudiesMaleMiddle AgedRNA, Viral/bloodSwitzerlandViral Load
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PMID: 18783328
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Research groups Swiss HIV Cohort Study
Unité HIV (46)
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KHANNA, Nina et al. CD4+ T cell count recovery in HIV type 1-infected patients is independent of class of antiretroviral therapy. In: Clinical Infectious Diseases, 2008, vol. 47, n° 8, p. 1093-101. https://archive-ouverte.unige.ch/unige:2102

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Deposited on : 2009-06-18

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