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

15 Citations (Scopus)

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

Fingerprint

Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
HIV-1
HIV
T-Lymphocytes
Therapeutics
Viral Load
Early Diagnosis

Keywords

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

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy. / Kulkarni, Hemant; Okulicz, Jason F.; Grandits, Greg; Crum-Cianflone, Nancy F.; Landrum, Michael L.; Hale, Braden; Wortmann, Glenn; Tramont, Edmund; Polis, Michael; Dolan, Matthew; Lifson, Alan R.; Agan, Brian K.; Ahuja, Sunil K; Marconi, Vincent C.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 57, No. 5, 15.08.2011, p. 387-395.

Research output: Contribution to journalArticle

Kulkarni, H, Okulicz, JF, Grandits, G, Crum-Cianflone, NF, Landrum, ML, Hale, B, Wortmann, G, Tramont, E, Polis, M, Dolan, M, Lifson, AR, Agan, BK, Ahuja, SK & Marconi, VC 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, vol. 57, no. 5, pp. 387-395. https://doi.org/10.1097/QAI.0b013e3182219113
Kulkarni, Hemant ; Okulicz, Jason F. ; Grandits, Greg ; Crum-Cianflone, Nancy F. ; Landrum, Michael L. ; Hale, Braden ; Wortmann, Glenn ; Tramont, Edmund ; Polis, Michael ; Dolan, Matthew ; Lifson, Alan R. ; Agan, Brian K. ; Ahuja, Sunil K ; Marconi, Vincent C. / Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy. In: Journal of Acquired Immune Deficiency Syndromes. 2011 ; Vol. 57, No. 5. pp. 387-395.
@article{0360d07161aa4e4ba5b3d0ee1ef2287a,
title = "Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy",
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.",
keywords = "CD4 count, highly active antiretroviral therapy, outcomes, predictors, treatment response",
author = "Hemant Kulkarni and Okulicz, {Jason F.} and Greg Grandits and Crum-Cianflone, {Nancy F.} and Landrum, {Michael L.} and Braden Hale and Glenn Wortmann and Edmund Tramont and Michael Polis and Matthew Dolan and Lifson, {Alan R.} and Agan, {Brian K.} and Ahuja, {Sunil K} and Marconi, {Vincent C.}",
year = "2011",
month = "8",
day = "15",
doi = "10.1097/QAI.0b013e3182219113",
language = "English (US)",
volume = "57",
pages = "387--395",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "0894-9255",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Early postseroconversion CD4 cell counts independently predict CD4 cell count recovery in HIV-1-postive subjects receiving antiretroviral therapy

AU - Kulkarni, Hemant

AU - Okulicz, Jason F.

AU - Grandits, Greg

AU - Crum-Cianflone, Nancy F.

AU - Landrum, Michael L.

AU - Hale, Braden

AU - Wortmann, Glenn

AU - Tramont, Edmund

AU - Polis, Michael

AU - Dolan, Matthew

AU - Lifson, Alan R.

AU - Agan, Brian K.

AU - Ahuja, Sunil K

AU - Marconi, Vincent C.

PY - 2011/8/15

Y1 - 2011/8/15

N2 - 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.

AB - 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.

KW - CD4 count

KW - highly active antiretroviral therapy

KW - outcomes

KW - predictors

KW - treatment response

UR - http://www.scopus.com/inward/record.url?scp=80051550219&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051550219&partnerID=8YFLogxK

U2 - 10.1097/QAI.0b013e3182219113

DO - 10.1097/QAI.0b013e3182219113

M3 - Article

VL - 57

SP - 387

EP - 395

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 0894-9255

IS - 5

ER -