tailieunhanh - Báo cáo y học: " Long-term CD4+ lymphocyte response following HAART initiation in a U.S. Military prospective cohort"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Long-term CD4+ lymphocyte response following HAART initiation in a . Military prospective cohort. | Lifson et al. AIDS Research and Therapy 2011 8 2 http content 8 1 2 AIDS RESEARCH AND THERAPY RESEARCH Open Access Long-term CD4 lymphocyte response following HAART initiation in a . Military prospective cohort Alan R Lifson1 8 Elizabeth M Krantz2 8 Lynn E Eberly2 8 Matthew J Dolan3 Vincent C Marconi4 Amy C Weintrob5 8 Nancy F Crum-Cianflone6 8 Anuradha Ganesan7 8 Patricia L Grambsch2 8 Brian K Agan8 for the Infectious Disease Clinical Research Program IDCRP HIV Working Group8 Abstract Background Among HIV-infected persons initiating highly active antiretroviral therapy HAART early CD4 lymphocyte count increases are well described. However whether CD4 levels continue to increase or plateau after 4-6 years is controversial. Methods To address this question and identify other determinants of CD4 response we analyzed data for 1 846 persons from a prospective HIV military cohort study who initiated HAART who had post-HAART CD4 measurements and for whom HIV seroconversion SC date was estimated. Results CD4 count at HAART initiation was 200 cells mm3 for 23 201-349 for 31 350-499 for 27 and 500 for 19 . The first 6 months post-HAART the greatest CD4 increases 93-151 cells occurred with lesser increases 22-36 cells year through the first four years. Although CD4 changes for the entire cohort were relatively flat thereafter HIV viral load VL suppressors showed continued increases of 12-16 cells year. In multivariate analysis adjusting for baseline CD4 and post-HAART time interval CD4 responses were poorer in those with longer time from HIV SC to HAART start lower pre-HAART CD4 nadir higher pre-HAART VL and clinical AIDS before HAART P . Conclusions Small but positive long-term increases in CD4 count in virally suppressed patients were observed. CD4 response to HAART is influenced by multiple factors including duration of preceding HIV infection and optimized if treatment is started with virally suppressive therapy as early as possible. .