Wright, S.Petoumenos, K.Boyd, M.Carr, A.Downing, S.O'Connor, C.Grotowski, M.Law, M.2019-05-162019-05-162013HIV Medicine, 2013; 14(4):208-2161464-26621468-1293http://hdl.handle.net/2440/119047The 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.en© 2012 British HIV AssociationAgeing; CD4 T‐cell count; HIV infection; long‐term; combination antiretroviral therapy responseJournal article003005552510.1111/j.1468-1293.2012.01053.x0003155884000022-s2.0-84874519116270358Boyd, M. [0000-0002-6848-3307]