Increased clinical events in HIV-infected patients who achieve full virologic suppression but fail to attain a CD4 count = 200 cells/mm3 after one year of combination antiretroviral therapy (cART).

1
Increased clinical events in HIV-infected
patients who achieve full virologic suppression
but fail to attain a CD4 count 200 cells/mm3
after one year of combination antiretroviral
therapy (cART).
M.R. Loutfy1,2, B. Yip3, D. Moore3, J. Raboud2,
S. Shen2, J.S.G. Montaner3, R. Hogg3
1Maple Leaf Medical Clinic, Toronto, Ontario
2University of Toronto, Toronto, Ontario
3British Columbia Centre for Excellence in
HIV/AIDS, Vancouver, British Columbia, Canada
Baseline Characteristics (n299)
Overall (n299) CD4 lt200 (n97) CD4 200 (n202) p-value
Age in years (median, IQR) 42 (35, 49) 43 (37, 49) 41 (35, 49) 0.430
Male 257 (86.0) 86 (88.7) 171 (84.7) 0.351
Injection Drugs 46 (15.4) 19 (19.6) 27 (13.4) 0.163
HIV-AIDS 81 (27.1) 34 (35.1) 47 (23.3) 0.32
Number of ARVs (median, IQR) 3 (3, 3) 3 (3, 3) 3 (3, 3) 1.00
NNRTI in first regimen 147 (49.2) 39 (40.2) 108 (53.3) 0.032
Viral Load (c/mL) (median, IQR) gt100,000 (71, gt100K) gt100,000 (69, gt100K) gt100,000 (75, gt100K) 0.664
CD4 (cells/mm3) (median, IQR) 80 (30, 140) 40 (10, 80) 120 (50, 160) lt0.001
Both p gt 0.05 CD4 lt200 CD4 200
n (after 1 year of cART) 97 patients (32.4) 202 patients (67.6)
Clinical events overall 10/97 (10.3) 17/202 (8.4)
Clinical events (after 1 year of cART) 4/97 (4.1) 5/202 (2.5)
Clinical event occurred at a median time of 2.2 months after initiation of cART. Clinical event occurred at a median time of 2.2 months after initiation of cART. Clinical event occurred at a median time of 2.2 months after initiation of cART.
Univariate Cox Regression All Clinical events
HR 95 CI p-value
Adherence gt95 0.34 0.15-0.77 0.009
Baseline CD4 0.46 per 100 cells 0.23-0.92 0.027
Time-dependent CD4 0.48 per 100 cells 0.30-0.77 0.002
Failure to attain CD4 200 3.08 0.98-9.71 0.055
Univariate Cox Regression Clinical events after
Year 1
HR 95 CI p-value
Adherence gt95 0.17 0.04-0.62 0.008
Baseline CD4 1.05 per 100 cells 0.36-3.07 0.934
Time-dependent CD4 0.42 per 100 cells 0.21-0.86 0.017
Failure to attain CD4 200 3.94 0.85-18.2 0.080
Correspondence mloutfy_at_nygh.on.ca Acknowledgement
s We thank Bonnie Devlin, Elizabeth Ferris,
Nada Gataric, Kelly Hsu, Myrna Reginaldo , and
Peter Vann for their research and administrative
assistance.