@article{PAR00010221,
  title = {{M}ean {CD}4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings},
  author = {{C}almy, {A}. and {B}alestre, {E}. and {B}onnet, {F}. and {B}oulle, {A}. and {S}prinz, {E}. and {W}ood, {R}. and {D}elaporte, {E}ric and {M}essou, {E}. and {M}c{I}ntyre, {J}. and {E}l {F}ilali, {K}. {M}. and {S}chechter, {M}. and {K}umarasamy, {N}. and {B}angsberg, {D}. and {M}c{P}hail, {P}. and {V}an der {B}orght, {S}. and {Z}ala, {C}. and {E}gger, {M}. and {T}hiebaut, {R}. and {D}abis, {F}. and {A}rt-{L}inc {I}e{DEA} {C}ollaboration {A}sia},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {C}hanges in {CD}4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment ({ART}) in resource-limited settings. {W}e assessed the impact of on-going {HIV}-{RNA} replication on {CD}4 cell count slopes in patients treated with a first-line combination {ART}. {M}ethod: {N}aive patients on a first-line {ART} regimen with at least two measures of {HIV}-{RNA} available after {ART} initiation were included in the study. {T}he relationships between mean {CD}4 cell count change and {HIV}-{RNA} at 6 and 12 months after {ART} initiation ({M}6 and {M}12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting {ART}. {R}esults: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median {CD}4 cell count at {ART} initiation of 107 cells/mu {L}. {A}ll patients with suppressed {HIV}-{RNA} at {M}12 had a continuous increase in {CD}4 cell count up to 18 months after treatment initiation. {B}y contrast, any degree of {HIV}-{RNA} replication both at {M}6 and {M}12 was associated with a flat or a decreasing {CD}4 cell count slope. {M}ultivariable analysis using {HIV}-{RNA} thresholds of 10,000 and 5,000 copies confirmed the significant effect of {HIV}-{RNA} on {CD}4 cell counts both at {M}6 and {M}12. {C}onclusion: {I}n routinely monitored patients on an {NNRTI}-based first-line {ART}, on-going low-level {HIV}-{RNA} replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of {ART}.},
  keywords = {{HIV}-1 ; {CD}4 count ; {CD}4 slope ; {HIV}-{RNA} threshold ; {R}esource limited ; settings},
  booktitle = {},
  journal = {{B}mc {I}nfectious {D}iseases},
  volume = {12},
  numero = {},
  pages = {147},
  ISSN = {1471-2334},
  year = {2012},
  DOI = {10.1186/1471-2334-12-147},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00010221},
}