Does Discordancy Between the CD4 Count and CD4 Percentage in HIV-Positive Individuals Influence Outcomes on Highly Active Antiretroviral Therapy?
Autor: | Mark, Gompels, David T, Dunn, Andrew, Phillips, Debbie, Dooley, Andrew, De Burgh Thomas, Jane, Anderson, Frank, Post, Deenan, Pillay, Brian, Gazzard, Teresa, Hill, Margaret, Johnson, Richard, Gilson, Loveleen, Bansi, Philippa, Easterbrook, Martin, Fisher, John, Walsh, Chloe, Orkin, Jonathan, Ainsworth, Clifford, Leen, Caroline, Sabin, Sundhiya, Mandalia |
---|---|
Rok vydání: | 2012 |
Předmět: |
Adult
Male Percentile medicine.medical_specialty Anti-HIV Agents Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Injection drug use Acquired immunodeficiency syndrome (AIDS) Antiretroviral Therapy Highly Active Internal medicine Humans Immunology and Allergy Medicine Clinical significance business.industry Clinical events Middle Aged medicine.disease Antiretroviral therapy CD4 Lymphocyte Count Treatment Outcome Infectious Diseases Immunology Female Drug Monitoring business Viral load |
Zdroj: | The Journal of Infectious Diseases. 205:540-547 |
ISSN: | 1537-6613 0022-1899 |
Popis: | INTRODUCTION The CD4 count and CD4 percentage (CD4%) are both strong predictors of clinical disease progression in human immunodeficiency virus (HIV). Although individuals may show discordancy between their CD4 count and CD4%, the clinical relevance of this is unclear. METHODS Discordancy was defined where the CD4% was ≤10th percentile for a selected CD4 count range (referred to as low discordancy), within the central 80% range (concordant), or ≥90th percentile (high discordancy). Regression methods identified factors associated with low and high discordancy in untreated individuals and assessed the impact of discordancy on treatment responses to highly active antiretroviral therapy (HAART). RESULTS High discordancy was associated with female sex, low viral load, and white ethnicity; low discordancy was associated with black or nonwhite ethnicity, older age, and injection drug use. Clinical event rates were higher in individuals with high discordancy starting HAART, but there was no association with subsequent HIV progression by 6 months after starting HAART. CD4 count increases remained lower, by 20 cells/mm(3), in individuals with low discordancy, and higher, by 27 cells/mm(3), in those with high discordancy. CONCLUSIONS Overall discrepancies between the CD4/CD4% are small, confirming the use of absolute CD4 counts as a monitoring tool. |
Databáze: | OpenAIRE |
Externí odkaz: |