%0 Journal Article
%T Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings
%A Alexandra Calmy
%A Eric Balestre
%A Fabrice Bonnet
%A Andrew Boulle
%A Eduardo E Sprinz
%A Robin Wood
%A Eric Delaporte
%A Eug¨¨ne Messou
%A James McIntyre
%A Kamal Marhoum El Filaili
%A Mauro Schechter
%A N Kumarasamy
%A David Bangsberg
%A Patrick McPhail
%A Stefaan Van Der Borght
%A Carlos Zala
%A Matthias Egger
%A Rodolphe Thi¨¦baut
%A Fran£¿ois Dabis
%J BMC Infectious Diseases
%D 2012
%I BioMed Central
%R 10.1186/1471-2334-12-147
%X Na£¿ve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12£¿months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART.3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6£¿years, a median age of 34£¿years, and a median CD4 cell count at ART initiation of 107 cells/¦ÌL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18£¿months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12.In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.
%K HIV-1
%K CD4 count
%K CD4 slope
%K HIV-RNA threshold
%K Resource limited settings
%U http://www.biomedcentral.com/1471-2334/12/147/abstract