Ageing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience

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dc.contributor.authorWright, S.
dc.contributor.authorPetoumenos, K.
dc.contributor.authorBoyd, M.
dc.contributor.authorCarr, A.
dc.contributor.authorDowning, S.
dc.contributor.authorO'Connor, C.
dc.contributor.authorGrotowski, M.
dc.contributor.authorLaw, M.
dc.date.issued2013
dc.description.abstractThe aim of this study was to describe the long-term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to a long-term decline in the immune system via low-grade chronic immune activation/inflammation, then one might expect to see a greater or earlier decline in CD4 counts in older HIV-positive patients with increasing duration of cART.Retrospective and prospective data were examined from long-term virologically stable HIV-positive adults from the Australian HIV Observational Database. We estimated mean CD4 cell count changes following the completion of 5 years of cART using linear mixed models.A total of 37 916 CD4 measurements were observed for 892 patients over a combined total of 9753 patient-years. Older patients (> 50 years old) at cART initiation had estimated mean (95% confidence interval) changes in CD4 counts by year-5 CD4 count strata (< 500, 500-750 and > 750 cells/μL) of 14 (7 to 21), 3 (-5 to 11) and -6 (-17 to 4) cells/μL/year. Of the CD4 cell count rates of change estimated, none were indicative of long-term declines in CD4 cell counts.Our results suggest that duration of cART and increasing age do not result in decreasing mean changes in CD4 cell counts for long-term virologically suppressed patients, indicating that the level of immune recovery achieved during the first 5 years of treatment is sustained through long-term cART.
dc.description.statementofresponsibilityST Wright, K Petoumenos, M Boyd, A Carr, S Downing, CC O'Connor, M Grotowski, MG Law, on behalf of the Australian HIV Observational Database study group
dc.identifier.citationHIV Medicine, 2013; 14(4):208-216
dc.identifier.doi10.1111/j.1468-1293.2012.01053.x
dc.identifier.issn1464-2662
dc.identifier.issn1468-1293
dc.identifier.orcidBoyd, M. [0000-0002-6848-3307]
dc.identifier.urihttp://hdl.handle.net/2440/119047
dc.language.isoen
dc.publisherWiley-Blackwell
dc.rights© 2012 British HIV Association
dc.source.urihttps://doi.org/10.1111/j.1468-1293.2012.01053.x
dc.subjectAgeing; CD4 T‐cell count; HIV infection; long‐term; combination antiretroviral therapy response
dc.titleAgeing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience
dc.typeJournal article
pubs.publication-statusPublished

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