Decreasing CD4+ T-cell count during suppressed or low-level viraemia in patients with HIV infection.

Published

Journal Article

BACKGROUND: Suboptimal improvement in CD4+ T-cell count is not uncommon in HIV-infected patients with suppressed plasma HIV RNA levels, and a decrease in CD4+ T-cell count in patients with suppressed or low-level viraemia has been observed. METHODS: Our objectives were to identify the prevalence of decreasing CD4+ T-cell counts during suppressed or low-level viraemia, to determine the frequency of clinical events during and immediately after such decreases, and to examine for associations with individual variables. A matched case-control study was undertaken using the Duke Infectious Diseases Clinic database (n = 3,949). Cases had at least two consecutive significant decreases in either CD4+ absolute count or CD4+ percentage, while also having plasma HIV RNA levels < 1,000 copies/ml. RESULTS: The prevalence of decreasing CD4+ T-cell counts during suppressed or low-level viraemia was 1.22%. Only three HIV-associated clinical events occurred. The majority of cases had an increase in the CD4+ T-cell count immediately following the study period. The use of either zidovudine or stavudine was weakly associated with decreasing CD4+ T-cell counts in a multivariable analysis, but this association was not present in cases with only a decrease in CD4+ T-cell percentage. CONCLUSIONS: Decreasing CD4+ T-cell counts during suppressed or low-level viraemia are rare, typically transient, and not associated with an increase in HIV-associated clinical events.

Full Text

Duke Authors

Cited Authors

  • Anderson, AML; Kosinski, AS; Bartlett, JA

Published Date

  • 2007

Published In

Volume / Issue

  • 12 / 7

Start / End Page

  • 1041 - 1048

PubMed ID

  • 18018762

Pubmed Central ID

  • 18018762

International Standard Serial Number (ISSN)

  • 1359-6535

Language

  • eng

Conference Location

  • England