Sub-optimal CD4 reconstitution despite viral suppression in an urban cohort on Antiretroviral Therapy (ART) in sub-Saharan Africa: Frequency and clinical significance

AIDS Research and Therapy

Volumn 5, Issue , 2008, Pages

  Nakanjako, Damalie ^a   Kiragga, Agnes ^a   Ibrahim, Fowzia ^b   Castelnuovo, Barbara ^a   Kamya, Moses R ^a   Easterbrook, Philippa J ^a,b  

^a MAKERERE UNIVERSITY   (Uganda)

^b KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIRETROVIRUS AGENT; EFAVIRENZ; EFAVIRENZ PLUS LAMIVUDINE PLUS ZIDOVUDINE; LAMIVUDINE; LAMIVUDINE PLUS NEVIRAPINE PLUS STAVUDINE; UNCLASSIFIED DRUG; VIRUS RNA; ZIDOVUDINE;

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ADULT; AFRICA; ARTICLE; CD4+ T LYMPHOCYTE; COHORT ANALYSIS; FEMALE; HIGHLY ACTIVE ANTIRETROVIRAL THERAPY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; LOGISTIC REGRESSION ANALYSIS; LYMPHOCYTE COUNT; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; PROSPECTIVE STUDY; UGANDA; URBAN AREA; VIRUS INHIBITION;

EID: 58149100332     PISSN: 17426405     EISSN: None     Source Type: Journal    
DOI: 10.1186/1742-6405-5-23     Document Type: Article

References (31)

1. Weidle PJ Malamba S Mwebaze R Sozi C Rukundo G Downing R Hanson D Ochola D Mugyenyi P Mermin J et al. Assessment of a pilot antiretroviral drug therapy programme in Uganda: Patients' response, survival, and drug resistance Lancet 2002, 360(9326):34-40. 10.1016/S0140-6736(02)09330-3 12114039
2. Porter K Walker S Hill T Anderson J Leen C Johnson M Gazzard B Walsh J Fisher M Orkin C et al. Changes in outcome of persons initiating highly active antiretroviral therapy at a CD4 count less than 50 Cells/mm3 J Acquir Immune Defic Syndr 2008, 47(2):202-205. 17971709
3. Piketty C Castiel P Belec L Batisse D Si Mohamed A Gilquin J Gonzalez-Canali G Jayle D Karmochkine M Weiss L et al. Discrepant responses to triple combination antiretroviral therapy in advanced HIV disease Aids 1998, 12(7):745-750. 10.1097/00002030-199807000-00011 9619806
4. Grabar S Le Moing V Goujard C Leport C Kazatchkine MD Costagliola D Weiss L Clinical outcome of patients with HIV-1 infection according to immunologic and virologic response after 6 months of highly active antiretroviral therapy Ann Intern Med 2000, 133(6):401-410. 10975957
5. Lawn SD Myer L Bekker LG Wood R CD4 cell count recovery among HIV-infected patients with very advanced immunodeficiency commencing antiretroviral treatment in sub-Saharan Africa BMC Infect Dis 2006, 6:59. 1435908 16551345 10.1186/1471-2334-6-59
6. Tuboi SH Brinkhof MW Egger M Stone RA Braitstein P Nash D Sprinz E Dabis F Harrison LH Schechter M Discordant responses to potent antiretroviral treatment in previously naive HIV-1-infected adults initiating treatment in resource-constrained countries: The antiretroviral therapy in low-income countries (ART-LINC) collaboration J Acquir Immune Defic Syndr 2007, 45(1):52-59. 10.1097/QAI.0b013e318042e1c3 17460471
7. Tan R Westfall AO Willig JH Mugavero MJ Saag MS Kaslow RA Kempf MC Clinical outcome of HIV-infected antiretroviral-naive patients with discordant immunologic and virologic responses to highly active antiretroviral therapy J Acquir Immune Defic Syndr 2008, 47(5):553-558. 10.1097/QAI.0b013e31816856c5 18285713
8. Lawn SD Myer L Harling G Orrell C Bekker LG Wood R Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: Implications for program evaluation Clin Infect Dis 2006, 43(6):770-776. 10.1086/507095 16912954
9. Easterbrook PJ HIV immune reconstitution syndrome in sub-Saharan Africa Aids 2008, 22(5):643-645. 18317006
10. Hazenberg MD Otto SA van Benthem BH Roos MT Coutinho RA Lange JM Hamann D Prins M Miedema F Persistent immune activation in HIV-1 infection is associated with progression to AIDS Aids 2003, 17(13):1881-1888. 10.1097/ 00002030-200309050-00006 12960820
11. Teixeira L Valdez H McCune JM Koup RA Badley AD Hellerstein MK Napolitano LA Douek DC Mbisa G Deeks S et al. Poor CD4 T cell restoration after suppression of HIV-1 replication may reflect lower thymic function Aids 2001, 15(14):1749-1756. 10.1097/ 00002030-200109280-00002 11579235
12. Kamya MR Mayanja-Kizza H Kambugu A Bakeera-Kitaka S Semitala F Mwebaze-Songa P Castelnuovo B Schaefer P Spacek LA Gasasira AF te al. Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy J Acquir Immune Defic Syndr 2007, 46(2):187-193. 10.1097/QAI.0b013e31814278c0 17693883
13. Florence E Lundgren J Dreezen C Fisher M Kirk O Blaxhult A Panos G Katlama C Vella S Phillips A Factors associated with a reduced CD4 lymphocyte count response to HAART despite full viral suppression in the EuroSIDA study HIV Med 2003, 4(3):255-262. 10.1046/ j.1468-1293.2003.00156.x 12859325
14. Kaufmann GR Furrer H Ledergerber B Perrin L Opravil M Vernazza P Cavassini M Bernasconi E Rickenbach M Hirschel B et al. Characteristics, determinants, and clinical relevance of CD4 T cell recovery to <500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy Clin Infect Dis 2005, 41(3):361-372. 10.1086/ 431484 16007534
15. Moore D Montaner J Total lymphocyte counts and ART in resource-limited settings Lancet 2005, 366(9500):1831-1832. 10.1016/S0140-6736(05)67736-7 16310537
16. Badolato R Immunological nonresponse to highly active antiretroviral therapy in HIV-infected subjects: Is the bone marrow impairment causing CD4 lymphopenia? Clin Infect Dis 2008, 46(12):1911-1912. 10.1086/588481 18462176
17. Nakanjako D Kyabayinze DJ Mayanja-Kizza H Katabira E Kamya MR Eligibility for HIV/AIDS treatment among adults in a medical emergency setting at an urban hospital in Uganda Afr Health Sci 2007, 7(3):124-128. 2269717 18052863
18. Huttner AC Kaufmann GR Battegay M Weber R Opravil M Treatment initiation with zidovudine-containing potent antiretroviral therapy impairs CD4 cell count recovery but not clinical efficacy Aids 2007, 21(8):939-946. 10.1097/QAD.0b013e3280f00fd6 17457087
19. Jevtovic DJ Salemovic D Ranin J Pesic I Zerjav S Djurkovic-Djakovic O The prevalence and risk of immune restoration disease in HIV-infected patients treated with highly active antiretroviral therapy HIV Med 2005, 6(2):140-143. 10.1111/j.1468-1293.2005.00277.x 15807721
20. Sloand EM Kumar PN Kim S Chaudhuri A Weichold FF Young NS Human immunodeficiency virus type 1 protease inhibitor modulates activation of peripheral blood CD4(+) T cells and decreases their susceptibility to apoptosis in vitro and in vivo Blood 1999, 94(3):1021-1027. 10419894
21. WHO Antiretroviral therapy for HIV infection in adults and adolescents in resource limited settings: Towards universal access Recommendations for a public health approach 2006.
22. Patterson K Napravnik S Eron J Keruly J Moore R Effects of age and sex on immunological and virological responses to initial highly active antiretroviral therapy HIV Med 2007, 8(6):406-410. 10.1111/ j.1468-1293.2007.00485.x 17661850
23. Aiuti F Mezzaroma I Failure to reconstitute CD4+ T-cells despite suppression of HIV replication under HAART AIDS Rev 2006, 8(2):88-97. 16848276
24. Omland LH Weis N Skinhoj P Laursen A Christensen PB Nielsen HI Moller A Engsig F Sorensen HT Obel N Impact of hepatitis B virus co-infection on response to highly active antiretroviral treatment and outcome in HIV-infected individuals: A nationwide cohort study HIV Med 2008, 9(5):300-306. 10.1111/j.1468-1293.2008.00564.x 18400077
25. Eggena MP Barugahare B Okello M Mutyala S Jones N Ma Y Kityo C Mugyenyi P Cao H T cell activation in HIV-seropositive Ugandans: Differential associations with viral load, CD4+ T cell depletion, and coinfection J Infect Dis 2005, 191(5):694-701. 10.1086/427516 15688282
26. Borkow G Weisman Z Leng Q Stein M Kalinkovich A Wolday D Bentwich Z Helminths, human immunodeficiency virus and tuberculosis Scand J Infect Dis 2001, 33(8):568-571. 10.1080/00365540110026656 11525348
27. Sterne JA Hernan MA Ledergerber B Tilling K Weber R Sendi P Rickenbach M Robins JM Egger M Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: A prospective cohort study Lancet 2005, 366(9483):378-384. 10.1016/S0140-6736(05)67022-5 16054937
28. Lawn SD Myer L Orrell C Bekker LG Wood R Early mortality among adults accessing a community-based antiretroviral service in South Africa: implications for programme design Aids 2005, 19(18):2141-2148. 16284464
29. Moore RD Keruly JC CD4+ cell count 6 years after commencement of highly active antiretroviral therapy in persons with sustained virologic suppression Clin Infect Dis 2007, 44(3):441-446. 10.1086/510746 17205456
30. Moore DM Hogg RS Yip B Wood E Tyndall M Braitstein P Montaner JS Discordant immunologic and virologic responses to highly active antiretroviral therapy are associated with increased mortality and poor adherence to therapy J Acquir Immune Defic Syndr 2005, 40(3):288-293. 10.1097/01.qai.0000182847.38098.d1 16249702
31. Smith DM Schooley RT Running with scissors: Using antiretroviral therapy without monitoring viral load Clin Infect Dis 2008, 46(10):1598-1600. 10.1086/587110 18419496