Safe Reduction in CD4 Cell Count Monitoring in Stable, Virally Suppressed Patients With HIV Infection or HIV/Hepatitis C Virus Coinfection.

Autor:	Nicolás D; Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona., Esteve A; Centre for Epidemiological Studies on HIV/STI in Catalonia - ASPC, CIBER Epidemiologia y Salud Publica., Cuadros A; University of Barcelona., Campbell CNJ; Centre for Epidemiological Studies on HIV/STI in Catalonia - ASPC, CIBER Epidemiologia y Salud Publica., Tural C; Fundació Lluita Contra la Sida, Fundacio Irsicaixa, Hospital Universitari Germans Trias i Pujol., Podzamczer D; Hospital Universitari de Bellvitge-Bellvitge Institute for Biomedical Research, Hospitalet de Llobregat., Murillas J; Hospital Universitario Son Espases., Homar F; Hospital Son Llàtzer, Palma de Mallorca., Segura F; Corporació Sanitària i Universitària Parc Taulí, Universitat Autónoma de Barcelona., Force L; Hospital de Mataró., Vilaró J; Hospital General de Vic., Masabeu À; Hospital de Palamós., Garcia I; Hospital General d'Hospitalet, Barcelona., Mercadal J; Hospital Alt Penedès de Vilafranca, Spain., Montoliu A; Centre for Epidemiological Studies on HIV/STI in Catalonia - ASPC, CIBER Epidemiologia y Salud Publica., Ferrer E; Hospital Universitari de Bellvitge-Bellvitge Institute for Biomedical Research, Hospitalet de Llobregat., Riera M; Hospital Universitario Son Espases., Cifuentes C; Hospital Son Llàtzer, Palma de Mallorca., Ambrosioni J; Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona., Navarro G; Corporació Sanitària i Universitària Parc Taulí, Universitat Autónoma de Barcelona., Manzardo C; Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona., Clotet B; Hospital Universitari de Bellvitge-Bellvitge Institute for Biomedical Research, Hospitalet de Llobregat., Gatell JM; Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona., Casabona J; Centre for Epidemiological Studies on HIV/STI in Catalonia - ASPC, CIBER Epidemiologia y Salud Publica., Miró JM; Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona., Murillas J, Manzardo C, Masabeu A, Mercadal J, Cifuentes C, Dalmau D, Domingo P, Falcó V, Curran A, Agustí C, Montoliu A, Pérez I, Curto J, Gargoulas F, Gómez A, Rubia JC, Zamora L, Blanco JL, Garcia-Alcaide F, Martínez E, Mallolas J, Llibre JM, Sirera G, Romeu J, Jou A, Negredo E, Saumoy M, Imaz A, Bolao F, Cabellos C, Peña C, DiYacovo S, Van Den Eynde E, Sala M, Cervantes M, Amengual MJ, Navarro M, Segura V, Barrufet P, Molina J, Alvaro M, Payeras T, Gracia Mateo M, Fernández J
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2016 Jun 15; Vol. 62 (12), pp. 1578-1585. Date of Electronic Publication: 2016 Apr 28.
DOI:	10.1093/cid/ciw157
Abstrakt:	Background: It has been suggested that routine CD4 cell count monitoring in human immunodeficiency virus (HIV)-monoinfected patients with suppressed viral loads and CD4 cell counts >300 cell/μL could be reduced to annual. HIV/hepatitis C virus (HCV) coinfection is frequent, but evidence supporting similar reductions in CD4 cell count monitoring is lacking for this population. We determined whether CD4 cell count monitoring could be reduced in monoinfected and coinfected patients by estimating the probability of maintaining CD4 cell counts ≥200 cells/µL during continuous HIV suppression. Methods: The PISCIS Cohort study included data from 14 539 patients aged ≥16 years from 10 hospitals in Catalonia and 2 in the Balearic Islands (Spain) since January 1998. All patients who had at least one period of 6 months of continuous HIV suppression were included in this analysis. Cumulative probabilities with 95% confidence intervals were calculated using the Kaplan-Meier estimator stratified by the initial CD4 cell count at the period of continuous suppression initiation. Results: A total of 8695 patients were included. CD4 cell counts fell to <200 cells/µL in 7.4% patients, and the proportion was lower in patients with an initial count >350 cells/µL (1.8%) and higher in those with an initial count of 200-249 cells/µL (23.1%). CD4 cell counts fell to <200 cells/µL in 5.7% of monoinfected and 11.1% of coinfected patients. Of monoinfected patients with an initial CD4 cell count of 300-349 cells/µL, 95.6% maintained counts ≥200 cells/µL. In the coinfected group with the same initial count, this rate was lower, but 97.6% of coinfected patients with initial counts >350 cells/µL maintained counts ≥200 cells/µL. Conclusions: From our data, it can be inferred that CD4 cell count monitoring can be safely performed annually in HIV-monoinfected patients with CD4 cell counts >300 cells/µL and HIV/HCV-coinfected patients with counts >350 cells/µL. (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.)
Databáze:	MEDLINE
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