Abstract
Background. Descriptions of the durability and consequences of immune reconstitution in patients who start highly active antiretroviral therapy (HAART) while severely immunosuppressed are limited. Methods. Patients with previous CD4+ cell counts <50 cells/mm3, all of whom had HAART-induced increases in CD4+ cell counts of >100 cells/mm3 on 2 separate occasions (measured sequentially at least 4 weeks apart), were enrolled in a prospective trial and observed every 16-32 weeks. Evaluations included assessments for new opportunistic complications, virologic (human immunodeficiency virus [HIV] RNA load) and immunologic (CD4+ cell count) responses, or death. Results. The median follow-up duration for 612 subjects was 184 weeks (range, 8-216 weeks). The rate of increase in CD4+ cell counts was ∼5.9 cells/mm3 every 8 weeks, with the degree of increase associated with the baseline HIV RNA load (<500 vs. ≥500 copies/mL). Subsequent measurements of virologic suppression based on HIV RNA levels were also associated with predicted CD4 + cell responses. Thirty-three AIDS-defining illnesses were reported (1.75 events per 100 person-years of follow-up); >40% (14 cases) occurred with higher than expected CD4+ cell counts. Conclusions. CD4 + cell count increases are related to virological control, with continuing increases seen in individuals who are immunosuppressed. Opportunistic illnesses and/or complications are infrequent but can occur at any time, even in patients who maintained an elevated CD4+ cell count.
Original language | English (US) |
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Pages (from-to) | 1500-1506 |
Number of pages | 7 |
Journal | Clinical Infectious Diseases |
Volume | 39 |
Issue number | 10 |
DOIs | |
State | Published - Nov 15 2004 |
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases