The prognosis of patients with dissociated virological and immunological responses to HAART - 03/12/10
pages | 5 |
Iconographies | 2 |
Vidéos | 0 |
Autres | 0 |
Abstract |
Background |
While HAART allows for the reconstitution of immune functions in most treated HIV patients, failure to achieve a significant increase in circulating CD4+ T cells despite undetectable viremia occurs.
Methods |
A retrospective study was conducted to evaluate the treatment outcome in a subgroup of 232 patients who after 3.1 years of treatment had not achieved desirable immune reconstitution despite a good virological response to HAART.
Results |
After a further 3.6±2.4 years of HAART, 82 (35.3%) patients achieved immune reconstitution (565.2±174.6 CD4 cells/μl), while 149 (64.2%) patients did not (268.8±91.1 cells/μl); the difference in the achieved CD4 counts between these subgroups was significant (P<0.01). One patient experienced treatment failure. Eleven patients died to the end of follow-up, of which 10 with a continuously dissociated response. Factors associated with immune recovery included clinical AIDS at HAART initiation (OR: 0.4, 95% CI: 0.24–0.81, P<0.01), usage of PIs and of drugs from all three classes (OR: 1.7, 95% CI: 1.0–3.0, P=0.046 and OR: 4.5, 95% CI: 1.15–18.19, P=0.03, respectively), and a rise in CD4 count to over 200 cells/μl after the first 3.1 years of treatment (OR: 5.3 95% CI: 2.6–11.0, P<0.01). Achievement of a rise in CD4 count to over 200 cells/μl after the first 3.1 years of treatment was an independent predictor of immune reconstitution in the following period.
Conclusion |
If patients on HAART reach CD4 cell counts of above 200 cells/μl in the first 3 years, immune recovery is possible after at least 6 years of treatment.
Le texte complet de cet article est disponible en PDF.Keywords : HIV, HAART, Virological/immunological dissociation
Plan
Vol 64 - N° 10
P. 692-696 - décembre 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?