Negative influence of age on CD4⁺ cell recovery after highly active antiretroviral therapy in naïve HIV-1-infected patients with severe immunodeficiency

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• 作者：Dariela Micheloud ; Juan Berenguer ; Jose M. Belló ; n ; Pilar Miralles ; Jaime Cosin ; Juan Carlos Lopez-Bernaldo de Quiros ; Matilde Sá ; nchez Conde ; M. Á ; ngeles Muñ ; oz-Ferná ; ndez ; Salvador Resino
• 关键词：HAART ; Age ; CD4⁺ ; Viral load ; Survival ; AIDS ; Recovery
• 刊名：Journal of Infection
• 出版年：2008
• 出版时间：February 2008
• 年：2008
• 卷：56
• 期：2
• 页码：130-136
• 全文大小：258 K

文摘

Summary

Objective

To study the effect of age on several outcomes among 187 antiretroviral-naive infected patients who started highly active antiretroviral therapy (HAART) with ≤200 CD4⁺/μl.

Methods

We carried out a retrospective study to determine the hazard ratio (HR) to reach an outcome in patients who experienced a change from the baseline in CD4⁺ counts of at least +100, +200, +300, +400 and +500 cells/μl at any moment during the follow-up and the odds ratio (OR) of achieving and maintaining a CD4⁺ value above a certain setpoint during at least 6, 12 or 18 months.

Results

The adjusted HR for an increase of +400 CD4⁺/μl and +500 CD4⁺/μl were 1.3 (95 % CI: 1.1; 1.5) and 1.3 (95 % CI: 1.1; 1.6) times slower for each additional 5 years of age at baseline. In addition, for every 5 years of extra age, the adjusted OR to achieve an absolute CD4⁺ cell count >500/μl at 6, 12 and 18 months after the initiation of HAART were 2.2 (95 % CI: 1.5; 3.2), 1.8 (95 % CI: 1.2; 2.6), and 1.8 (95 % CI: 1.2; 2.9) times less likely, respectively. We also found that patients ≥45 years old had worse complete CD4⁺ recovery (CD4⁺ > 500 cells/μl) than patients <45 years old.

Conclusion

The CD4⁺ recovery after HAART is a prolonged and continuous process which extends for several years. Age at baseline is inversely correlated with the magnitude and speed of CD4⁺ recovery among HIV-1 infected patients.