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Elevated CD8 T-cell counts and virological failure in HIV-infected patients after combination antiretroviral therapy

Authors
 Nam Su Ku  ;  Awachana Jiamsakul  ;  Oon Tek Ng  ;  Evy Yunihastuti  ;  Do Duy Cuong  ;  Man Po Lee  ;  Benedict Lim Heng Sim  ;  Praphan Phanuphak  ;  Wing-Wai Wong  ;  Adeeba Kamarulzaman  ;  Fujie Zhang  ;  Sanjay Pujari  ;  Romanee Chaiwarith  ;  Shinichi Oka  ;  Mahiran Mustafa  ;  Nagalingeswaran Kumarasamy  ;  Kinh Van Nguyen  ;  Rossana Ditangco  ;  Sasisopin Kiertiburanakul  ;  Tuti Parwati Merati  ;  Nicolas Durier  ;  Jun Yong Choi 
Citation
 Medicine, Vol.95(32) : 4570, 2016 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Anti-HIV Agents/administration & dosage ; Anti-HIV Agents/therapeutic use* ; CD8-Positive T-Lymphocytes*/drug effects ; Drug Therapy, Combination ; Female ; HIV Infections/blood ; HIV Infections/drug therapy* ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Treatment Failure ; Viral Load/drug effects
Keywords
cART ; CD8 ; HIV ; virological failure
Abstract
Elevated CD8 counts with combination antiretroviral therapy (cART) initiation may be an early warning indicator for future treatment failure. Thus, we investigated whether elevated CD8 counts were associated with virological failure (VF) in the first 4 years of cART in Asian HIV-infected patients in a multicenter regional cohort.We included patients from the TREAT Asia HIV Observational Database (TAHOD). Patients were included in the analysis if they started cART between 1996 and 2013 with at least one CD8 measurement within 6 months prior to cART initiation and at least one CD8 and viral load (VL) measurement beyond 6 months after starting cART. We defined VF as VL ≥400?copies/mL after 6 months on cART. Elevated CD8 was defined as CD8 ≥1200?cells/μL. Time to VF was modeled using Cox regression analysis, stratified by site.In total, 2475 patients from 19 sites were included in this analysis, of whom 665 (27%) experienced VF in the first 4 years of cART. The overall rate of VF was 12.95 per 100 person-years. In the multivariate model, the most recent elevated CD8 was significantly associated with a greater hazard of VF (HR?=?1.35, 95% CI 1.14-1.61; P?=?0.001). However, the sensitivity analysis showed that time-lagged CD8 measured at least 6 months prior to our virological endpoint was not statistically significant (P?=?0.420).This study indicates that the relationship between the most recent CD8 count and VF was possibly due to the CD8 cells reacting to the increase in VL rather than causing the VL increase itself. However, CD8 levels may be a useful indicator for VF in HIV-infected patients after starting cART.
Files in This Item:
T201603066.pdf Download
DOI
10.1097/MD.0000000000004570
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151841
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