+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impaired CD4 T-cell count response to combined antiretroviral therapy in antiretroviral-naive HIV-infected patients presenting with tuberculosis as AIDS-defining condition

Impaired CD4 T-cell count response to combined antiretroviral therapy in antiretroviral-naive HIV-infected patients presenting with tuberculosis as AIDS-defining condition

Clinical Infectious Diseases 54(6): 853-861

The impact of human immunodeficiency virus (HIV)-associated tuberculosis on CD4 T-cell count response to combined antiretroviral therapy (cART) is poorly investigated. A collaborative analysis including HIV-infected patients prospectively enrolled in 4 Italian clinical cohorts was conducted. Patients were grouped according to Centers for Disease Control and Prevention stage at the start of cART as having tuberculosis, having AIDS but not tuberculosis (nontuberculosis AIDS), and not having AIDS (AIDS free). Time to CD4 T-cell count of at least 100, 200, and 300 cells/μL above pre-cART levels and to CD4 T-cell count of >500 cells/μL were major end points. Survival analysis with time-fixed and time-dependent covariates was used. A total of 6528 patients were eligible; 125 patients (2%) had tuberculosis, 1062 (16%) had nontuberculosis AIDS, and 5341 (82%) were AIDS free. Patients with tuberculosis had a significantly reduced chance of CD4 T-cell count increase compared with AIDS-free patients as well as those with nontuberculosis AIDS, regardless of the primary outcome considered for a given value of confounders measured at baseline (eg, for >200 cells/μL above baseline; relative hazard, 0.71; P = .02), although it was no longer significant after further adjustment for current level of viral load suppression (relative hazard, 0.80; P = .11). There was a trend for reduced virological response in patients treated concomitantly for tuberculosis and HIV infection compared with those who were treated separately in time (P = .09). HIV-infected patients starting cART with a tuberculosis diagnosis showed an impaired immune recovery to cART compared with AIDS-free patients and those with nontuberculosis AIDS. It seems to be driven mainly by a delay in achieving viral suppression. Whether this may be due to interactions between antituberculosis drugs and antiretrovirals needs to be investigated.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 053728608

Download citation: RISBibTeXText

PMID: 22157323

DOI: 10.1093/cid/cir900

Related references

Reference curves for CD4 T-cell count response to combination antiretroviral therapy in HIV-1-infected treatment-naïve patients. HIV Medicine 18(1): 33-44, 2017

Rate of AIDS diseases or death in HIV-infected antiretroviral therapy-naive individuals with high CD4 cell count. Aids 21(13): 1717-1721, 2007

CD4+ cell count responses to antiretroviral therapy are not impaired in HIV-infected individuals with tuberculosis co-infection. Aids 29(11): 1363-1368, 2015

Treatment and CD4+ T cell count recovery among antiretroviral therapy-naive patients with HIV/AIDS. Clinical Infectious Diseases 49(10): 1619-1620, 2009

Optimal timing for initiation of highly active antiretroviral therapy in treatment-naïve human immunodeficiency virus-1-infected individuals presenting with AIDS-defining diseases: the experience of the PISCIS Cohort. Clinical Microbiology and Infection 19(7): 646-653, 2013

Burden of non-AIDS-defining and non-virus-related cancers among HIV-infected patients in the combined antiretroviral therapy era. Aids Research and Human Retroviruses 29(8): 1097-1104, 2013

Use of statins and risk of AIDS-defining and non-AIDS-defining malignancies among HIV-1 infected patients on antiretroviral therapy. Aids 28(16): 2407-2415, 2014

Effects of tuberculosis on the kinetics of CD4(+) T cell count among HIV-infected patients who initiated antiretroviral therapy early after tuberculosis treatment. Aids Research and Human Retroviruses 29(2): 226-230, 2013

Virologic response to antiretroviral therapy in chronically HIV-1-infected, antiretroviral-naive adults with baseline genotypic resistance. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 333, 2001

Inverse correlation of initial CD8 lymphocyte count and CD4 lymphocyte response to combination antiretroviral therapy in treatment-naive HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes 59(1): E1-E3, 2012

Good response to lopinavir/ritonavir-containing antiretroviral regimens in antiretroviral-naive HIV-2-infected patients. Aids 23(9): 1171-1173, 2009

Endothelial function in human immunodeficiency virus-infected antiretroviral-naive subjects before and after starting potent antiretroviral therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s. Journal of the American College of Cardiology 52(7): 569-576, 2008

Difference of progression to AIDS according to CD4 cell count, plasma HIV RNA level and the use of antiretroviral therapy among HIV patients infected through blood products in japan. Journal of Epidemiology 16(3): 101-106, 2006

Highly active antiretroviral therapy in a cohort of antiretroviral-naive HIV-infected patients after a long follow-up. AIDS 12(Suppl. 4): S42, 1998

Circulating levels of interleukin-7 in antiretroviral-naïve and highly active antiretroviral therapy-treated HIV-infected patients. HIV Clinical Trials 2(2): 108-112, 2001