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Home >> Publications >> Ageing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience.

Publication

Author(s):

Wright ST, Petoumenos K, Boyd M, Carr A, Downing S, O'Connor CC, Grotowski M, Law MG; Australian HIV Observational Database (AHOD) study group.

Pub Title:

Ageing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience.

Pub Date:

Apr 30 2013

Pub Region(s):

Asia-Pacific

Journal Issue:

4

Page Number:
208-16

Journal:

Title: 
HIV Medicine
Link: 
http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1293.2012.01053.x/abstract

PubMed: 23036045
Pub PDF: PDF icon hiv1053.pdf

Abstract
OBJECTIVES
: The aim of this study was to describe the long-term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to a long-term decline in the immune system via low-grade chronic immune activation/inflammation, then one might expect to see a greater or earlier decline in CD4 counts in older HIV-positive patients with increasing duration of cART.

METHODS: Retrospective and prospective data were examined from long-term virologically stable HIV-positive adults from the Australian HIV Observational Database. We estimated mean CD4 cell count changes following the completion of 5 years of cART using linear mixed models.

RESULTS: A total of 37 916 CD4 measurements were observed for 892 patients over a combined total of 9753 patient-years. Older patients (> 50 years old) at cART initiation had estimated mean (95% confidence interval) changes in CD4 counts by year-5 CD4 count strata (< 500, 500-750 and > 750 cells/μL) of 14 (7 to 21), 3 (-5 to 11) and -6 (-17 to 4) cells/μL/year. Of the CD4 cell count rates of change estimated, none were indicative of long-term declines in CD4 cell counts.

CONCLUSIONS: Our results suggest that duration of cART and increasing age do not result in decreasing mean changes in CD4 cell counts for long-term virologically suppressed patients, indicating that the level of immune recovery achieved during the first 5 years of treatment is sustained through long-term cART.

© 2012 British HIV Association.

PMID: 23036045 [PubMed - indexed for MEDLINE]

PMCID: PMC3556360 [Available on 2014/4/1]

 

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Citation:

Wright ST, Petoumenos K, Boyd M, Carr A, Downing S, O'Connor CC, Grotowski M, Law MG; Australian HIV Observational Database study group. Ageing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience. HIV Med. 2013 Apr;14(4):208-16. doi: 10.1111/j.1468-1293.2012.01053.x. Epub 2012 Oct 4. PubMed PMID: 23036045; PubMed Central PMCID: PMC3556360.