Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART

A proportion of HIV-patients does not normally restore their CD4 counts despite virological response to HAART. Those whose CD4 counts persistently remain closed to the critical threshold for opportunistic infections deserve special interest. To study the risk factors, the long-term CD4 counts evolut...

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Autores: Pacheco, Yolanda M., Jarrín, Inma, Amo, Julia del, Moreno, Santiago, Iribarren, José A., Viciana, Pompeyo, Parra, Jorge, Gomez-Sirvent, Juan L., Gutiérrez, Félix, Blanco, José Ramón, Vidal, Francesc, Leal, Manuel
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2009
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/389547
Acceso en línea:http://hdl.handle.net/10261/389547
https://api.elsevier.com/content/abstract/scopus_id/73949156929
Access Level:acceso abierto
Palabra clave:Risk factors and mortality
CD4 counts
CD4 restoration
Cohort
HAART
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spelling Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAARTPacheco, Yolanda M.Jarrín, InmaAmo, Julia delMoreno, SantiagoIribarren, José A.Viciana, PompeyoParra, JorgeGomez-Sirvent, Juan L.Gutiérrez, FélixBlanco, José RamónVidal, FrancescLeal, ManuelRisk factors and mortalityCD4 countsCD4 restorationCohortHAARTA proportion of HIV-patients does not normally restore their CD4 counts despite virological response to HAART. Those whose CD4 counts persistently remain closed to the critical threshold for opportunistic infections deserve special interest. To study the risk factors, the long-term CD4 counts evolution, and the risk of death of patients who persistently maintain low CD4 counts, despite virological response to HAART, within a multicenter, hospital-based cohort study. A total of 147 patients were selected from CoRIS-MD and classified into a "Low-Group" or a "High-Group", depending on their CD4 counts after two-years of effective HAART (threshold 250 cells/microL). Associated risk factors were analysed by logistic regression, the CD4 dynamics were evaluated over a total period of 7.70 years (IQR, 6.70-9.00), and mortality was estimated by Cox proportional hazard. A total of 40 patients (27%) were classified into the "Low-Group". The odds ratio for this group increased with age, being 4.56 (2.23-9.33) for over 40, and was also higher among IDU, 3.63 (1.04-12.68). Six years thereafter, among these patients, only a 30% exceeded 350 CD4 cells/microL and a 12% exceeded 500 CD4 cells/microL. Furthermore, the "Low-Group" had a death rate of 2.42 per 100 persons/year (95%CI, 1.01-5.81), although once adjusted by age the estimates were no longer significant [4.14 (0.87-19.72)]. Our results suggest that those HIV patients who have not overcome the critical threshold of 250 CD4 cells/microL after a two years period of virologically effective HAART do persist with the aforementioned failure of CD4 restoration for a much longer time.This work was supported by grants from the Spanish AIDS Research Network of Excellence (RIS; Red de Investigación en SIDA) (RD06/0006/0021 and E4120070099508), Fundación para la Investigación y la Prevención del SIDA en España (FIPSE) (366884/07), Consejería de Salud of Junta de Andalucía (PI0366/07 and the Excellence Project P06-CTS-01579), and Fondos de Investigación Sanitaria (FIS) (EC07/90392 and CP07/00240).Peer reviewedBentham Science PublishersRed Española de Investigación en SIDAFundación para la Investigación y la Prevención del Sida en EspañaJunta de AndalucíaInstituto de Salud Carlos IIIConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202520252009info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Postprintinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttp://hdl.handle.net/10261/389547https://api.elsevier.com/content/abstract/scopus_id/73949156929reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttps://doi.org/10.2174/157016209789973673Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/3895472026-05-22T06:33:51Z
dc.title.none.fl_str_mv Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
title Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
spellingShingle Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
Pacheco, Yolanda M.
Risk factors and mortality
CD4 counts
CD4 restoration
Cohort
HAART
title_short Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
title_full Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
title_fullStr Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
title_full_unstemmed Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
title_sort Risk factors, CD4 long-term evolution and mortality of HIV-infected patients who persistently maintain low CD4 counts, despite virological response to HAART
dc.creator.none.fl_str_mv Pacheco, Yolanda M.
Jarrín, Inma
Amo, Julia del
Moreno, Santiago
Iribarren, José A.
Viciana, Pompeyo
Parra, Jorge
Gomez-Sirvent, Juan L.
Gutiérrez, Félix
Blanco, José Ramón
Vidal, Francesc
Leal, Manuel
author Pacheco, Yolanda M.
author_facet Pacheco, Yolanda M.
Jarrín, Inma
Amo, Julia del
Moreno, Santiago
Iribarren, José A.
Viciana, Pompeyo
Parra, Jorge
Gomez-Sirvent, Juan L.
Gutiérrez, Félix
Blanco, José Ramón
Vidal, Francesc
Leal, Manuel
author_role author
author2 Jarrín, Inma
Amo, Julia del
Moreno, Santiago
Iribarren, José A.
Viciana, Pompeyo
Parra, Jorge
Gomez-Sirvent, Juan L.
Gutiérrez, Félix
Blanco, José Ramón
Vidal, Francesc
Leal, Manuel
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Red Española de Investigación en SIDA
Fundación para la Investigación y la Prevención del Sida en España
Junta de Andalucía
Instituto de Salud Carlos III
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Risk factors and mortality
CD4 counts
CD4 restoration
Cohort
HAART
topic Risk factors and mortality
CD4 counts
CD4 restoration
Cohort
HAART
description A proportion of HIV-patients does not normally restore their CD4 counts despite virological response to HAART. Those whose CD4 counts persistently remain closed to the critical threshold for opportunistic infections deserve special interest. To study the risk factors, the long-term CD4 counts evolution, and the risk of death of patients who persistently maintain low CD4 counts, despite virological response to HAART, within a multicenter, hospital-based cohort study. A total of 147 patients were selected from CoRIS-MD and classified into a "Low-Group" or a "High-Group", depending on their CD4 counts after two-years of effective HAART (threshold 250 cells/microL). Associated risk factors were analysed by logistic regression, the CD4 dynamics were evaluated over a total period of 7.70 years (IQR, 6.70-9.00), and mortality was estimated by Cox proportional hazard. A total of 40 patients (27%) were classified into the "Low-Group". The odds ratio for this group increased with age, being 4.56 (2.23-9.33) for over 40, and was also higher among IDU, 3.63 (1.04-12.68). Six years thereafter, among these patients, only a 30% exceeded 350 CD4 cells/microL and a 12% exceeded 500 CD4 cells/microL. Furthermore, the "Low-Group" had a death rate of 2.42 per 100 persons/year (95%CI, 1.01-5.81), although once adjusted by age the estimates were no longer significant [4.14 (0.87-19.72)]. Our results suggest that those HIV patients who have not overcome the critical threshold of 250 CD4 cells/microL after a two years period of virologically effective HAART do persist with the aforementioned failure of CD4 restoration for a much longer time.
publishDate 2009
dc.date.none.fl_str_mv 2009
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Postprint
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/389547
https://api.elsevier.com/content/abstract/scopus_id/73949156929
url http://hdl.handle.net/10261/389547
https://api.elsevier.com/content/abstract/scopus_id/73949156929
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://doi.org/10.2174/157016209789973673
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Bentham Science Publishers
publisher.none.fl_str_mv Bentham Science Publishers
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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