Details:

Alternative Title:
J Acquir Immune Defic Syndr
Publisher's site:
http://dx.doi.org/10.1097/QAI.0000000000000885
Personal Author:
Myers, Julie E. ; Xia, Qiang ; Torian, Lucia V. ; Irvine, Mary ; Harriman, Graham ; ... More +
Myers, Julie E. ; Xia, Qiang ; Torian, Lucia V. ; Irvine, Mary ; Harriman, Graham ; Sepkowitz, Kent A. ; Shepard, Colin W. ; Less -
Description:
Introduction: The evidence has begun to mount for diminishing the frequency of CD4 count testing. To determine whether these observations were applicable to an urban US population, we used New York City (NYC) surveillance data to explore CD4 testing among stable patients in NYC, 2007–2013. Methods: We constructed a population-based retrospective open cohort analysis of NYC HIV surveillance data. HIV+ patients aged ≥13 years with stable viral suppression (≥1 viral load the previous year; all <400 copies per milliliter) and immune status (≥1 CD4 the previous year; all ≥200 cells per cubic millimeter) entered the cohort the following year beginning January 1, 2007. Each subsequent year, eligible patients not previously included entered the cohort on January 1. Outcomes were annual frequency of CD4 monitoring and probability of maintaining CD4 ≥200 cells per cubic millimeter. A multivariable Cox model identified factors associated with maintaining CD4 ≥200 cells per cubic millimeter. Results: During 1.9 years of observation (median), 62,039 patients entered the cohort. The mean annual number of CD4 measurements among stable patients was 2.8 and varied little by year or characteristic. Two years after entering, 93.4% and 97.8% of those with initial CD4 350–499 and CD4 ≥500 cells per cubic millimeter, respectively, maintained CD4 ≥200 cells per cubic millimeter. Compared to those with initial CD4 ≥500 cells per cubic millimeter, those with CD4 200–349 cells per cubic millimeter and CD4 350–499 cells per cubic millimeter were more likely to have a CD4 <200 cells per cubic millimeter, controlling for sex, race, age, HIV risk group, and diagnosis year. Conclusions: In a population-based US cohort with well-controlled HIV, the probability of maintaining CD4 ≥200 cells per cubic millimeter for ≥2 years was >90% among those with initial CD4 ≥350 cells per cubic millimeter, suggesting that limited CD4 monitoring in these patients is appropriate.
Subject:
[+]
Adolescent
Adult
Aged
CD4 Lymphocyte Count
Cohort Studies
Epidemiology And Prevention
Female
HIV Infections
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Young Adult

Source:
J Acquir Immune Defic Syndr. 2015 ; 71(3):e73-e78.;
Pubmed ID:
26536317
Pubmed Central ID:
PMC4770377
Document Type:
Journal Article ;
Funding:
P30 CA008748/CA/NCI NIH HHS/United States ; K23 AI113185/AI/NIAID NIH HHS/United States ; PS1-1103/PS/NCHHSTP CDC HHS/United States ; T32 AI07140/AI/NIAID NIH HHS/United States ;
P30 CA008748/CA/NCI NIH HHS/United States ; K23 AI113185/AI/NIAID NIH HHS/United States ; PS1-1103/PS/NCHHSTP CDC HHS/United States ; T32 AI07140/AI/NIAID NIH HHS/United States ; Less -
Place as Subject:
New York City, NY ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:315c6372fb01ed3069becfe479bed9c36d443e4f37386bab237829d5f9485821
File Type:

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