OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/microL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/microL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/microL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads < 5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.CONCLUSIONS:Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.

Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption / Mussini, Cristina; Touloumi, G; Bakoyannis, G; Sabin, C; Castagna, A; Sighinolfi, L; Erikson, Le; Bratt, G; Borghi, V; Lazzarin, A; Cossarizza, Andrea; Esposito, R.. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - STAMPA. - 52:5(2009), pp. 588-594. [10.1097/QAI.0b013e3181b9e94d]

Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption

MUSSINI, Cristina;COSSARIZZA, Andrea;
2009

Abstract

OBJECTIVE:The extent of immune reconstitution following HAART resumption after 1 cycle of treatment interruption (TI) is not well known.METHODS:Multicenter retrospective analysis of patients who discontinued HAART with a CD4 > 500 cells/microL. Cox proportional hazards models were used to identify prognostic factors for immunologic response after treatment resumption. CD4 trends were investigated using linear mixed models.RESULTS:One hundred and eighty-three individuals were included. Median CD4 at TI and at treatment restart were 748 and 459 cells/microL, respectively. Median time from TI to treatment restart was 5.52 months. Ninety percent of the patients reached an undetectable viral load. One hundred and twenty-five subjects experienced immunologic response; 66 patients reached their pre-TI CD4 levels. At 3, 6, 12, and 24 months after treatment restart, the median CD4 increase was 149, 153, 161, and 178 cells/microL, respectively. Subjects with less steep CD4 declines during TI tended to have a lower initial CD4 increase, as did those reinitiating HAART with viral loads < 5000 copies/mL, whereas subjects who had experienced a virologic response to their initial HAART regimen had slower CD4 increases.CONCLUSIONS:Patients willing to discontinue treatment should be advised that immune reconstitution to pre-TI values is possible in fewer than 50% of patients at 2 years after treatment restart.
2009
52
5
588
594
Magnitude and Determinants of CD4 Recovery After HAART Resumption After 1 Cycle of Treatment Interruption / Mussini, Cristina; Touloumi, G; Bakoyannis, G; Sabin, C; Castagna, A; Sighinolfi, L; Erikson, Le; Bratt, G; Borghi, V; Lazzarin, A; Cossarizza, Andrea; Esposito, R.. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - STAMPA. - 52:5(2009), pp. 588-594. [10.1097/QAI.0b013e3181b9e94d]
Mussini, Cristina; Touloumi, G; Bakoyannis, G; Sabin, C; Castagna, A; Sighinolfi, L; Erikson, Le; Bratt, G; Borghi, V; Lazzarin, A; Cossarizza, Andrea; Esposito, R.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/707789
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