Background: The aim of the study was to quantify the risk of a drop in CD4+ counts below 200 cells/mL after reaching values >350 cells/mL on antiretroviral therapy (ART) (or after starting ART with CD4+ count >350 cells/mL) in the absence of virological failure. Setting: Ambulatory care services, Italy. Methods: Prospective cohort study of patients enrolled in the ICONA Foundation Study cohort who started ART with >350 CD4+/μL or with ≤350 CD4+/μL and reached values >350 cells/μL after virological suppression (VS, defined by 2 consecutive viral loads ≤50 copies/mL). The date of CD4 count >350 was the baseline for the analysis and those with ≥1 viral load and CD4+ count after baseline were included. The primary end point was the cumulative risk (estimated using the Kaplan-Meier method) of a CD4+ drop below 200 cells/μL over follow-up, which was censored at the date of virological failure (confirmed HIV-RNA >50 copies/mL), death, or last visit. Results: Six thousand six hundred sixty-three patients were included. A confirmed CD4+ drop below 200 cells/μL was never observed over a median follow-up of 45 (Q1: 21, Q3: 89) months, as long as VS was maintained. Upper limits of the 97.5% confidence interval of rates of confirmed CD4+ drop below 200 cells/μL were 0.28 and 0.38/1000 person-years of follow-up for patients with ≤350 and >350 CD4+ cells/μL at starting ART. Conclusions: In patients who started ART in Italy with >350 CD4+ cells/μL or reached >350 CD4+ cells/μL after VS, the risk of a CD4+ drop below 200 cells/μL in those maintaining VS was negligible.

Gianotti, N., Marchetti, G., Antinori, A., Saracino, A., Gori, A., Rizzardini, G., et al. (2017). Drop in CD4+ Counts Below 200 Cells/μL After Reaching (or Starting From) Values Higher than 350 Cells/μL in HIV-Infected Patients With Virological Suppression. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 76(4), 417-422 [10.1097/QAI.0000000000001522].

Drop in CD4+ Counts Below 200 Cells/μL After Reaching (or Starting From) Values Higher than 350 Cells/μL in HIV-Infected Patients With Virological Suppression

Puoti M.;Bonfanti P.;Lapadula G.;
2017

Abstract

Background: The aim of the study was to quantify the risk of a drop in CD4+ counts below 200 cells/mL after reaching values >350 cells/mL on antiretroviral therapy (ART) (or after starting ART with CD4+ count >350 cells/mL) in the absence of virological failure. Setting: Ambulatory care services, Italy. Methods: Prospective cohort study of patients enrolled in the ICONA Foundation Study cohort who started ART with >350 CD4+/μL or with ≤350 CD4+/μL and reached values >350 cells/μL after virological suppression (VS, defined by 2 consecutive viral loads ≤50 copies/mL). The date of CD4 count >350 was the baseline for the analysis and those with ≥1 viral load and CD4+ count after baseline were included. The primary end point was the cumulative risk (estimated using the Kaplan-Meier method) of a CD4+ drop below 200 cells/μL over follow-up, which was censored at the date of virological failure (confirmed HIV-RNA >50 copies/mL), death, or last visit. Results: Six thousand six hundred sixty-three patients were included. A confirmed CD4+ drop below 200 cells/μL was never observed over a median follow-up of 45 (Q1: 21, Q3: 89) months, as long as VS was maintained. Upper limits of the 97.5% confidence interval of rates of confirmed CD4+ drop below 200 cells/μL were 0.28 and 0.38/1000 person-years of follow-up for patients with ≤350 and >350 CD4+ cells/μL at starting ART. Conclusions: In patients who started ART in Italy with >350 CD4+ cells/μL or reached >350 CD4+ cells/μL after VS, the risk of a CD4+ drop below 200 cells/μL in those maintaining VS was negligible.
Articolo in rivista - Articolo scientifico
Antiretroviral therapy; Cd4; +; cells count; CD4; +; count dipping; CD4; +; count monitoring; Virological suppression
English
2017
76
4
417
422
none
Gianotti, N., Marchetti, G., Antinori, A., Saracino, A., Gori, A., Rizzardini, G., et al. (2017). Drop in CD4+ Counts Below 200 Cells/μL After Reaching (or Starting From) Values Higher than 350 Cells/μL in HIV-Infected Patients With Virological Suppression. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 76(4), 417-422 [10.1097/QAI.0000000000001522].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/304334
Citazioni
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 2
Social impact