Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy

Hemant Kulkarni, Jason F. Okulicz, Greg Grandits, Nancy F. Crum-Cianflone, Michael L. Landrum, Braden Hale, Glenn Wortmann, Edmund Tramont, Michael Polis, Matthew Dolan, Alan R. Lifson, Brian K. Agan, Sunil K. Ahuja, Vincent C. Marconi

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: The relationship between CD4+ T-cell counts determined soon after seroconversion with HIV-1 (baseline CD4+), nadir CD4+, and CD4+ levels attained during highly active antiretroviral therapy (HAART) is unknown. Methods: Longitudinal, including baseline (at or soon after HIV diagnosis), intermediate (nadir), and distal (post-HAART) CD4+ T-cell counts were assessed in 1085 seroconverting subjects who achieved viral load suppression from a large well-characterized cohort. The association of baseline with post-HAART CD4+ T-cell count was determined after adjustment for other relevant covariates. RESULTS:: A higher baseline CD4+ T-cell count predicted a greater post-HAART CD4+ T-cell count, independent of the nadir and other explanatory variables. Together, baseline and nadir strongly predicted the post-HAART CD4+ count such that a high baseline and lower nadir were associated with a maximal immune recovery after HAART. Likelihood of recovery of the baseline count after HAART was significantly higher when the nadir/baseline count ratio was consistently 0.6. Conclusions: Among viral load suppressing seroconverters, the absolute CD4+ T-cell count attained post-HAART is highly dependent on both baseline and nadir CD4+ T-cell counts. These associations further support the early diagnosis and initiation of HAART among HIV-infected persons.

Original languageEnglish (US)
Pages (from-to)387-395
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume57
Issue number5
DOIs
StatePublished - Aug 15 2011

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Keywords

  • CD4 count
  • highly active antiretroviral therapy
  • outcomes
  • predictors
  • treatment response

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Kulkarni, H., Okulicz, J. F., Grandits, G., Crum-Cianflone, N. F., Landrum, M. L., Hale, B., Wortmann, G., Tramont, E., Polis, M., Dolan, M., Lifson, A. R., Agan, B. K., Ahuja, S. K., & Marconi, V. C. (2011). Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 57(5), 387-395. https://doi.org/10.1097/QAI.0b013e3182219113