Long-term Mortality in HIV-Positive Individuals Virally Suppressed for >3 Years With Incomplete CD4 Recovery
Long-term Mortality in HIV-Positive Individuals Virally Suppressed for >3 Years With Incomplete CD4 Recovery
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DOI：
10.1093/cid/ciu038
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发表时间：
2014-05-01
影响因子：
11.8
通讯作者：
Obel, Niels
中科院分区：
文献类型：
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作者：
Engsig, Frederik N.;Zangerle, Robert;Obel, Niels
背景。一些人类免疫缺陷病毒 (HIV) 感染者在 CD4 计数较低的情况下开始联合抗逆转录病毒治疗 (cART)，可实现病毒抑制，但无法恢复 CD4 细胞。我们的目的是确定 (1) 持续病毒抑制 3 年后未能达到 CD4 计数>200 个细胞/μL 的风险因素，以及 (2) 所达到的 CD4 计数与随后死亡率的关联。方法。我们纳入了来自 2 个大型国际 HIV 队列的接受治疗的 HIV 感染成年人，他们进行了病毒抑制（3 年，CD4 细胞数为 200 个细胞/μL。CD4 细胞数为 200 个细胞/μL 的个体。在不同患者组和所有死因中都观察到死亡率增加。结论。接受 cART 治疗的病毒抑制的 HIV 阳性个体，如果 CD4 计数未达到 >200 个细胞/μL，则长期死亡率大幅增加。
Background. Some human immunodeficiency virus (HIV)-infected individuals initiating combination antiretroviral therapy (cART) with low CD4 counts achieve viral suppression but not CD4 cell recovery. We aimed to identify (1) risk factors for failure to achieve CD4 count >200 cells/mu L after 3 years of sustained viral suppression and (2) the association of the achieved CD4 count with subsequent mortality.Methods. We included treated HIV-infected adults from 2 large international HIV cohorts, who had viral suppression (3 years with CD4 count 200 cells/mu L. Individuals with CD4 200 cells/mu L. The increased mortality was seen across different patient groups and for all causes of death.Conclusions. Virally suppressed HIV-positive individuals on cART who do not achieve a CD4 count >200 cells/mu L have substantially increased long-term mortality.