Abstract
OBJECTIVE: To assess the effect of baseline- and treatment-related factors on immunologic recovery after initiation of antiretroviral therapy (ART). METHODS: Nine hundred eighty antiretroviral-naive HIV-1+ subjects were randomized to start stavudine/didanosine or zidovudine/lamivudine with nelfinavir, efavirenz, or both nelfinavir and efavirenz. RESULTS: Greater CD4 cell recovery was associated with age of 40 years or younger, female sex, higher baseline naive/memory CD4 cell ratio, higher baseline virus load (VL), and virologic suppression (VS). Most subjects who maintained an undetectable VL had a substantial increase in CD4 cell count, but 13% of the subjects did not, even after 3 years of VS. Persistent T-cell activation was associated with lower CD4 cell recovery, even in subjects who achieved VS. Initial treatment assignment did not affect total CD4 cell recovery, naive/memory CD4 cell reconstitution, or decline in T-cell activation. In addition to CD4 cell recovery, B-cell counts rose substantially after ART initiation. CONCLUSIONS: In this large randomized trial, younger age, female sex, higher naive/memory CD4 cell ratio, higher baseline VL, and VS were associated with greater CD4 cell increase, whereas persistent T-cell activation was associated with impaired CD4 cell recovery after ART initiation. Initial treatment assignment did not affect CD4 cell reconstitution.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 426-434 |
| Number of pages | 9 |
| Journal | Journal of Acquired Immune Deficiency Syndromes |
| Volume | 42 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2006 |
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Keywords
- Antiretroviral therapy
- CD4 cell recovery
- HIV-1
- Immunologic outcomes
- Memory and naive CD4 cell subsets
- T-cell activation
ASJC Scopus subject areas
- Virology
- Immunology
Cite this
Effect of baseline- and treatment-related factors on immunologic recovery after initiation of antiretroviral therapy in HIV-1-positive subjects : Results from ACTG 384. / Gandhi, Rajesh T.; Spritzler, John; Chan, Ellen; Asmuth, David; Rodriguez, Benigno; Merigan, Thomas C.; Hirsch, Martin S.; Shafer, Robert W.; Robbins, Gregory K.; Pollard, Richard B.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 42, No. 4, 08.2006, p. 426-434.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of baseline- and treatment-related factors on immunologic recovery after initiation of antiretroviral therapy in HIV-1-positive subjects
T2 - Results from ACTG 384
AU - Gandhi, Rajesh T.
AU - Spritzler, John
AU - Chan, Ellen
AU - Asmuth, David
AU - Rodriguez, Benigno
AU - Merigan, Thomas C.
AU - Hirsch, Martin S.
AU - Shafer, Robert W.
AU - Robbins, Gregory K.
AU - Pollard, Richard B
PY - 2006/8
Y1 - 2006/8
N2 - OBJECTIVE: To assess the effect of baseline- and treatment-related factors on immunologic recovery after initiation of antiretroviral therapy (ART). METHODS: Nine hundred eighty antiretroviral-naive HIV-1+ subjects were randomized to start stavudine/didanosine or zidovudine/lamivudine with nelfinavir, efavirenz, or both nelfinavir and efavirenz. RESULTS: Greater CD4 cell recovery was associated with age of 40 years or younger, female sex, higher baseline naive/memory CD4 cell ratio, higher baseline virus load (VL), and virologic suppression (VS). Most subjects who maintained an undetectable VL had a substantial increase in CD4 cell count, but 13% of the subjects did not, even after 3 years of VS. Persistent T-cell activation was associated with lower CD4 cell recovery, even in subjects who achieved VS. Initial treatment assignment did not affect total CD4 cell recovery, naive/memory CD4 cell reconstitution, or decline in T-cell activation. In addition to CD4 cell recovery, B-cell counts rose substantially after ART initiation. CONCLUSIONS: In this large randomized trial, younger age, female sex, higher naive/memory CD4 cell ratio, higher baseline VL, and VS were associated with greater CD4 cell increase, whereas persistent T-cell activation was associated with impaired CD4 cell recovery after ART initiation. Initial treatment assignment did not affect CD4 cell reconstitution.
AB - OBJECTIVE: To assess the effect of baseline- and treatment-related factors on immunologic recovery after initiation of antiretroviral therapy (ART). METHODS: Nine hundred eighty antiretroviral-naive HIV-1+ subjects were randomized to start stavudine/didanosine or zidovudine/lamivudine with nelfinavir, efavirenz, or both nelfinavir and efavirenz. RESULTS: Greater CD4 cell recovery was associated with age of 40 years or younger, female sex, higher baseline naive/memory CD4 cell ratio, higher baseline virus load (VL), and virologic suppression (VS). Most subjects who maintained an undetectable VL had a substantial increase in CD4 cell count, but 13% of the subjects did not, even after 3 years of VS. Persistent T-cell activation was associated with lower CD4 cell recovery, even in subjects who achieved VS. Initial treatment assignment did not affect total CD4 cell recovery, naive/memory CD4 cell reconstitution, or decline in T-cell activation. In addition to CD4 cell recovery, B-cell counts rose substantially after ART initiation. CONCLUSIONS: In this large randomized trial, younger age, female sex, higher naive/memory CD4 cell ratio, higher baseline VL, and VS were associated with greater CD4 cell increase, whereas persistent T-cell activation was associated with impaired CD4 cell recovery after ART initiation. Initial treatment assignment did not affect CD4 cell reconstitution.
KW - Antiretroviral therapy
KW - CD4 cell recovery
KW - HIV-1
KW - Immunologic outcomes
KW - Memory and naive CD4 cell subsets
KW - T-cell activation
UR - http://www.scopus.com/inward/record.url?scp=33745891216&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745891216&partnerID=8YFLogxK
U2 - 10.1097/01.qai.0000226789.51992.3f
DO - 10.1097/01.qai.0000226789.51992.3f
M3 - Article
C2 - 16810109
AN - SCOPUS:33745891216
VL - 42
SP - 426
EP - 434
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
SN - 1525-4135
IS - 4
ER -