scholarly journals Inferior Clinical Outcome of the CD4+Cell Count–Guided Antiretroviral Treatment Interruption Strategy in the SMART Study: Role of CD4+Cell Counts and HIV RNA Levels during Follow‐up

2008 ◽  
Vol 197 (8) ◽  
pp. 1145-1155 ◽  
Author(s):  
Keyword(s):  
Antiretroviral Treatment ◽  
Treatment Interruption ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Smart Study ◽  
Cd4 Cell

Immunologic Benefits of Enfuvirtide in Patients Enrolled in a Drug Assistance Program

2008 ◽  
Vol 42 (5) ◽  
pp. 621-626 ◽  
Author(s):  
Parya Saberi ◽  
Nikolai H Caswell ◽  
Cristina I Gruta ◽  
Jason N Tokumoto ◽  
Betty J Dong
Keyword(s):  
Cell Count ◽  
Viral Suppression ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Background Regimen ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Cell Count Increase

Background: Randomized clinical trials have demonstrated that enfuvirtide plus an optimized background regimen can cause a significant increase in CD4+ cell counts and a reduction in HIV RNA levels. Objective: To describe and anaiyze CD4+ cell count and HIV RNA changes in HIV-infected patients receiving enfuvirtide and a prescribed background regimen (PBR) in a primarily clinical setting. Methods: A retrospective review from September 1998 through August 2005 of CD4+ cell counts and HIV RNA changes from baseline was conducted in patients receiving enfuvirtide. Data were stratified and analyzed according to baseline CD4+ cell count and HIV RNA. Results: A mean CD4+ cell count increase of approximately 102 cells/mm3 was observed, regardless of baseline CD4+ cell count, in 187 patients receiving enfuvirtide during a mean of 19.4 months of follow-up. During 3 years of follow-up, patients initiating enfuvirtide at CD4+ cell counts less than 100 cells/mm3 never achieved absolute CD4+ cell counts comparable to the counts in patients starting enfuvirtide at CD4+ cell counts of 100 cells/mm3 or more. In 38.3% of patients achieving an undetectable HIV RNA level, a mean CD4+ cell count increase of 185 cells/mm3 was observed. An unexpected finding was that a mean CD4+ cell count increase of 76 cells/mm3 occurred in 61.7% of patients not achieving complete viral suppression. Conclusions: Immunologic benefits were observed in subjects continuing enfuvirtide plus a PBR irrespective of baseline CD4+ cell count, complete viral suppression, or antiretroviral susceptibility data. Dala suggest that initiation of enfuvirtide at CD4+ cell counts greater than 100 celis/mm3 may be immunologically advantageous and independent of complete virologic response.

scholarly journals Randomized, double-blind trial comparing indinavir alone, zidovudine alone and indinavir plus zidovudine in antiretroviral therapy-naive hiv-infected individuals with CD4 cell counts between 50 and 250/mm3

2000 ◽  
Vol 42 (1) ◽  
pp. 27-36 ◽  
Author(s):  
David S. LEWI ◽  
Jamal M. SULEIMAN ◽  
David E. UIP ◽  
Rogerio J. PEDRO ◽  
Rosa A. SOUZA ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Event ◽  
Double Blind Study ◽  
Double Blind ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Risk Of Disease ◽  
Cd4 Cell

Treatment with indinavir has been shown to result in marked decreases in viral load and increases in CD4 cell counts in HIV-infected individuals. A randomized double-blind study to evaluate the efficacy of indinavir alone (800 mg q8h), zidovidine alone (200 mg q8h) or the combination was performed to evaluate progression to AIDS. 996 antiretroviral therapy-naive patients with CD4 cell counts of 50-250/mm3 were allocated to treatment. During the trial the protocol was amended to add lamivudine to the zidovudine-containing arms. The primary endpoint was time to development of an AIDS-defining illness or death. The study was terminated after a protocol-defined interim analysis demonstrated highly significant reductions in progression to a clinical event in the indinavir-containing arms, compared to the zidovudine arm (p<0.0001). Over a median follow-up of 52 weeks (up to 99 weeks), percent reductions in hazards for the indinavir plus zidovudine and indinavir groups compared to the zidovudine group were 70% and 61%, respectively. Significant reductions in HIV RNA and increases in CD4 cell counts were also seen in the indinavir-containing groups compared to the zidovudine group. Improvement in both CD4 cell count and HIV RNA were associated with reduced risk of disease progression. All three regimens were generally well tolerated.

scholarly journals Impact of HBV and HCV coinfection on CD4 cells among HIV-infected patients: a longitudinal retrospective study

2018 ◽  
Vol 12 (11) ◽  
pp. 1009-1018
Author(s):  
Claudinei Mesquita da Silva ◽  
Leyde Daiane de Peder ◽  
Eraldo S Silva ◽  
Isolde Previdelli ◽  
Omar Cleo Neves Pereira ◽  
...  
Keyword(s):  
Genotype 3 ◽  
Cd4 Cell Count ◽  
Hcv Genotype ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Hcv Genotype 1 ◽  
Hcv Coinfection ◽  
Cd4 Cell ◽  
The Impact

Introduction: The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. We aimed to examine the impact of HBV and HCV coinfection on CD4 cell count and CD4/CD8 ratio in adults with HIV. Methodology: We conducted a longitudinal retrospective study in Brazil between January 1, 2002, and June 30, 2016, including 205 patients with HIV monoinfection, 37 with HIV-HBV coinfection, 35 with HIV-HCV coinfection, and 62 with HIV-HCV (48 HCV genotype 1 and 14 HCV genotype 3). Results: Median duration of follow-up was 2,327 (interquartile range: 1,159–3,319) days. An increased CD4 cell count and CD4/CD8 ratio over time was observed in all groups receiving combined antiretroviral therapy (cART). Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was also no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during follow-up on cART. However, CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. HIV patients with HCV genotype 3 coinfection showed significantly lower CD4/CD8 ratio during follow-up on cART than those coinfected with HCV genotype 1 coinfection. No statistically significant effect of coinfection was observed on the efficacy of cART. Conclusions: HIV-infected patients are more likely to show better immunological responses to cART when they are not coinfected with HCV.

Effectiveness, safety, durability and immune recovery in a retrospective, multicentre, observational cohort of ART-experienced, HIV-1-infected patients receiving maraviroc

2017 ◽  
Vol 28 (11) ◽  
pp. 1067-1073 ◽  
Author(s):  
C Dentone ◽  
G Sterrantino ◽  
A Signori ◽  
G Cenderello ◽  
M Guerra ◽  
...  
Keyword(s):  
Mixed Model ◽  
Therapeutic Option ◽  
Immune Recovery ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
One Year ◽  
Cd4 Cell

The aim of this retrospective, multicentre, observational study was to assess the durability, safety, immune recovery and effectiveness on viral suppression of antiretroviral therapy (ART) in a maraviroc (MVC)-based cohort. We collected clinical, demographical, immunological and virological parameters of adult HIV patients who were infected by CCR5-tropic virus and started an ART regimen containing MVC from 2005 to 2012. We created a longitudinal mixed model to assess the change over time of data. We enrolled 126 drug-experienced patients; the median duration of MVC treatment was 25 months. The probability of stopping ART at one year was 13.3%, and at three years was 27.3%. Statistically significant changes were observed for CD4+ cell count increase ( p < 0.001), HIV-RNA decrease ( p < 0.001) and total cholesterol decrease ( p = 0.005). Ninety-four patients (79.7%) had CD4 ≥ 200 cells/mm3 at baseline while nine of them reached this threshold at nine months (7.6%), 17 (13%) after nine months and six (5%) remained below 200 cells/mm3 at the end of the study. Overall, 114 patients (90.5%) achieved an HIV-RNA ≤ 50 cp/ml. A majority of patients maintained CD4 cell counts of ≥ 200 cells/mm3 and achieved an undetectable HIV viral load within three months. MVC-containing regimens are safe and appear to be a feasible therapeutic option for ART.

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

scholarly journals Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Independent Risk Factors ◽  
Cd4 Cell

Abstract Background: The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).Methods: We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection. Results: In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that PNS patients with prednisone usage and lower CD4+ cell counts were independent risk factors of more likely to have PCP compared to controls (OR =3.39, p=0.002; OR =0.64, p=0.021p<0.05). All patients survived after treatment. Conclusion: PCP was not unusual in PNS patients, and the most important risk factors were prednisone usage and a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

Characteristics allelic of Human Leukocyte Antigen class I genotype and association with viral load and CD4 cell count in HIV-1 infected patients, Hanoi 2014 – 2016

2021 ◽  
Vol 31 (4) ◽  
pp. 43-50
Author(s):  
Tran Thi Minh Tam ◽  
Nguyen Thuy Linh ◽  
Phan Ha My ◽  
Nguyen Thi Lan Anh
Keyword(s):  
Viral Load ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Class I ◽  
Cd4 Cell Count ◽  
Leukocyte Antigen ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv 1

Human Leukocyte Antigen (HLA) class I plays a regulatory role in cellular immune response to HIV-1 infection. The role of HLA alleles in HIV progression via viral load and CD4 cell count is well known. HLA class I is polymorphic and distributed differently by nation. This descriptive cross-sectional study was performed on 303 HIV-1 infected patients in 2014 - 2016, with aims to (i) characterize HLA class I genotype with 4-digit nomenclature and (ii) identify specifc alleles in correlate with CD4 cell counts and HIV viral load. 117 allele genotypes have been identifed, including 28 HLA-A alleles, 54 HLA-B alleles and 35 HLA-C alleles. The results showed that the most prevalent alleles in the population include A*11:01 (30.7%), B*15:02 (15.2%) and C*08:01 (17.1%). The frequency of haplotype created from these alleles is 8.4%. A*02:03, B*46:01 related to gender and ethnicity respectively. In conclusion, the study provided detailed pattern of HLA class I expression in a study population of HIV-1 infected patients and reported for the frst time the associated B*51:01, C*14:02 alleles associated to an increase in CD4 cell counts.

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