Details:

Alternative Title:
J Int AIDS Soc
Publisher's site:
http://dx.doi.org/10.7448/IAS.16.1.17355
Personal Author:
Ekwaru, John P ; Campbell, James ; Malamba, Samuel ; Moore, David M ; Were, Willy ; ... More +
Ekwaru, John P ; Campbell, James ; Malamba, Samuel ; Moore, David M ; Were, Willy ; Mermin, Jonathan Less -
Description:
Introduction

HIV RNA viral load (VL) has been shown to increase during opportunistic illnesses (OIs), suggesting active HIV replication in response to infection among patients not taking antiretroviral therapy (ART). We assessed the effects of OIs on HIV RNA VL and CD4+ T cell counts among patients on ART with initially suppressed VL.

Methods

Between 2003 and 2007, we enrolled and followed 1094 HIV-1-infected adults who initiated ART and had quarterly blood draws for VL and CD4+ T cell count. In VL/CD4+ T cell measurement intervals following undetectable VL, we compared the elevation in VL to detectable levels and CD4+ T cell count changes between intervals when participants had episodes of OIs and intervals when they did not have OIs.

Results

VL was more likely to be detectable if participants had OIs in the prior three months compared to when they did not (OR=4.0 (95% CI=1.9–8.6)). The CD4+ T cell counts declined 24.1 cells/µL per three months in intervals where the participants had OIs compared to an increase of 21.3 cells/µL per three months in intervals where they did not have OIs (adjusted difference in the rate of CD4+ T cell count change of 61.7 cells/µL per three months (95% CI=13.7–109.7), P value=0.012). The rate of CD4+ T cell count increase was 25.6 cells/µL per three months (95% CI=11.6–39.6) higher for females compared to males (p value=<0.001), 1.4 cells/µL per three months lower per one year increase in age (p value=0.046) and 4 cells/µL per three months lower per 10 cells/µL increase in the starting CD4+ T cell count value (p value=<0.001).

Conclusion

Episodes of opportunistic infections among patients taking ART with undetectable VL were associated with elevation of HIV RNA VL to detectable levels and decline in CD4+ T cell counts.


Subjects:
[+]
Adult AIDS-Related Opportunistic Infections Anti-Retroviral Agents CD4 Lymphocyte Count Female HIV-1 HIV Infections Humans Male Plasma RNA, Viral Viral Load
Source:
J Int AIDS Soc. 2013; 16(1).
Series:
PEPFAR
Pubmed ID:
23547778
Pubmed Central ID:
PMC3615176
Document Type:
Journal Article
Funding:
D43 TW000003/TW/FIC NIH HHS/United States ; 1-D43-TW00003/TW/FIC NIH HHS/United States ; PEPFAR/United States
D43 TW000003/TW/FIC NIH HHS/United States ; 1-D43-TW00003/TW/FIC NIH HHS/United States ; PEPFAR/United States Less -
Place as Subject:
Uganda
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:9e9b8c75aed7ef38bbc3e3de0edfc6ab2f96e568251873a3c2f3eb33295e2de2
Download URL:
https://stacks.cdc.gov/view/cdc/13270/cdc_13270_DS1.pdf
File Type:

Supporting Files

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