Routine CD4 monitoring in HIV patients with viral suppression: Is it really necessary? A Portuguese cohort

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Nuno Pereira (Author) FMUP

Journal

The Journal is awaiting validation by the Administrative Services.

Title: JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION

Vol. 51

Pages: 593-597

ISSN: 1684-1182

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00P-PDW

DOI: 10.1016/j.jmii.2016.09.003

Abstract (EN): Purpose: CD4 cell-count has been regarded as the key surrogate marker for prognostic staging and therapeutic monitoring of HIV-infected individuals. Our purpose was to assess the probability of maintaining a CD4 count >200 cells/mL in patients with continuous viral suppression and CD4 cell counts >200 cells/mu L. Methods: Retrospective cohort study of HIV-infected patients, treatment naive, who started antiretroviral therapy between 2007 and 2011. We estimated the probability of maintaining CD4 counts >200 cells/mu L during continuous viral suppression using the Kaplan-Meier method. The hazard ratios of a CD4 count <200 cells/mu L were estimated and compared using Cox proportional hazards regression. Results: 401 patients were included: 70.1% men; median age 37 years; 98.8% HIV-1 infected. The median duration of continuous viral suppression with CD4 counts >200 cells/mu L was 40.5 months. Ninety-three percent of patients maintained CD4 counts >= 200 cells/mu L during the period of continuous viral suppression. Compared with those with an initial CD4 count >= 350 cells/mu L, patients with initial CD4 count <300 cells/mu L had a significantly higher risk of a CD4 count <200 cells/mu L. Patients with viral suppression and CD4 counts >= 350 cells/mu L had a 97.1% probability of maintaining CD4 cell counts >= 200 cells/mu L for 48 months. Conclusions: The probability of a CD4 count <200 cells/mu L in an HIV-infected patient with viral suppression and CD4 >= 350 cells/mu L was very low. These data suggests less frequent monitoring of CD4 counts in these patients. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5