Timing of antiretroviral therapy initiation after diagnosis of recent human immunodeficiency virus infection and CD4(+) T-cell recovery

Y Ding; S Duan; Z Wu; R Ye; Y Yang; S Yao; J Wang; L Xiang; Y Jiang; L Lu; M Jia; R Detels; N He

doi:10.1016/j.cmi.2015.11.007

Timing of antiretroviral therapy initiation after diagnosis of recent human immunodeficiency virus infection and CD4(+) T-cell recovery

Clin Microbiol Infect. 2016 Mar;22(3):290.e5-8. doi: 10.1016/j.cmi.2015.11.007. Epub 2015 Nov 25.

Authors

Y Ding¹, S Duan², Z Wu³, R Ye², Y Yang², S Yao², J Wang², L Xiang², Y Jiang³, L Lu⁴, M Jia⁴, R Detels⁵, N He⁶

Affiliations

¹ Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
² Dehong Prefecture Centre for Disease Control and Prevention, Mangshi, Yunnan Province, China.
³ National Centre for AIDS/STD Control and Prevention (NCAIDS), Chinese Centre for Disease Control and Prevention (China CDC), Beijing, China.
⁴ Yunnan Centre for Disease Control and Prevention, Kuming, Yunnan Province, China.
⁵ Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, USA.
⁶ Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China. Electronic address: [email protected].

PMID: 26627338
DOI: 10.1016/j.cmi.2015.11.007

Abstract

We retrospectively examined the timing of antiretroviral therapy (ART) initiation and CD4(+) T-cell recovery over 36 months among recent human immunodeficiency virus (HIV) infections using BED (HIV-1 subtypes B, E and D) immunoglobulin G capture enzyme immunoassay (BED-CEIA). Regardless of baseline CD4(+) counts, individuals (n = 393) who initiated ART >2 months after diagnosis had significantly decreased probability and rate of achieving CD4(+) counts ≥900 cells/μL or ≥600 cells/μL than those individuals (n = 135) who started ART earlier (≤2 months). But the mean CD4(+) counts in two groups converged after 30 months of treatment. Early ART initiation leads to accelerated CD4(+) recovery, but does not offer a long-term advantage in CD4(+) counts.

Keywords: Antiretroviral therapy; CD4(+)T cells; China; human immunodeficiency virus; immune recovery; recent infection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Anti-HIV Agents / therapeutic use
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count*
China
Female
HIV Infections / drug therapy*
HIV Infections / immunology*
HIV Infections / virology
HIV-1
Humans
Male
Middle Aged
RNA, Viral
Time-to-Treatment*
Treatment Outcome
Viral Load
Young Adult

Substances

Anti-HIV Agents
RNA, Viral