Reference curves for CD4 T-cell count response to combination antiretroviral therapy in HIV-1-infected treatment-naïve patients. HIV Medicine
Bouteloup et al. on behalf of COHERE in EuroCoord aimed to provide ‘reference curves’ for CD4 T-cell responses during the first 12 months of combination antiretroviral therapy (cART) for patients with virological suppression, according to the characteristics of the patients at cART initiation. Data on 27 cohorts across 35 European countries were provided for the present analysis. All persons aged ≥ 18 years who started cART for the first time between 1 January 2005 and 1 January 2010 and who had at least one available measurement of CD4 count and a viral load ≤ 50 HIV-1 RNA copies/mL 6 months after cART initiation were included in the study.
A total of 28 992 patients were included in the study. The median CD4 T-cell count at treatment initiation was 249. The median observed CD4 counts at 6, 9 and 12 months were 382, 402 and 420 cells/lL. The two main factors explaining the variation of CD4 count at 6 months were AIDS stage and CD4 count at cART initiation. A CD4 count increase of ≥ 100 cells/mL was generally required in order that patients stayed ‘on track’ (i.e. with a CD4 count at the same percentile as when they started), with slightly higher gains required for those who started with CD4 counts in the higher percentiles.
In conclusion, the study proposes reference curves for the CD4 count that may be used as an additional tool for the clinician when evaluating responses to cART. A web tool is available at http://shiny.isped.u-bordeaux.fr/CD4refcurves