Clinical Progression Rates by CD4 Cell Category Before and After the Initiation of Combination Antiretroviral Therapy (cART)
Marguerite Guiguet1, 2, *, Kholoud Porter3, Andrew Phillips4, Dominique Costagliola1, 2, Abdel Babiker3
Identifiers and Pagination:Year: 2008
First Page: 3
Last Page: 9
Publisher ID: TOAIDJ-2-3
Article History:Received Date: 3/1/2008
Revision Received Date: 17/1/2008
Acceptance Date: 22/1/2008
Electronic publication date: 12/2/2008
Collection year: 2008
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
Rates of AIDS defining event (ADE), serious ADE and death by CD4 and HIV RNA categories before and after combination antiretroviral therapy (cART) initiation are lacking for high CD4 counts.
Event rates were estimated within CD4 cell strata using a Poisson regression model adjusting for sex, exposure category, age, and current HIV RNA (<4, 4-4.99, ≥5 log copies/ml), and including an interaction term between the CD4 cell count and cART indicator.
7317 and 6376 persons contributed to "naïve " and "cART " groups respectively, of whom 3911 contributed to both. At the same CD4 level, the risk of ADE was nearly 2 fold higher during naive follow-up compared to cART for CD4 <500 cells/mm3. However, after adjustment for current HIV RNA, the risk of ADE became similar for both groups except for CD4 count <200 cells/mm3 when it is 35% (6-72%) higher for naives. The same results were observed for the risk of serious ADE. There was no evidence of a difference in risk of death between naive and cART follow-up at specific CD4 categories even after adjustment for HIV RNA.
Within CD4 cell strata above 200 cells/mm3, the risk of ADE before ART initiation is higher than it is following cART initiation.