ArticleJournal of acquired immune deficiency syndromes (1999)2008
Poor initial CD4+ recovery with antiretroviral therapy prolongs immune depletion and increases risk for AIDS and non-AIDS diseases.
Article in Journal of acquired immune deficiency syndromes (1999), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04062825 (Interaction of HIV/Platelets and HIV-platelets/Lymphocytes in HIV Patients Under cART Treatment But Immunological Non Responders), which is not on this map. Cited by 82 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Interaction of HIV/Platelets and HIV-platelets/Lymphocytes in HIV Patients Under cART Treatment But Immunological Non Responders
Who cites it
82 citing papers in PubMed, 2 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Pooled it
- Discordant Immune Response with Antiretroviral Therapy in HIV-1: A Systematic Review of Clinical Outcomes.PloS one · 2016Pooled it
- A Single Dose Study of Pembrolizumab in People With HIV Infection Who are Immunologic Nonresponders.Open forum infectious diseases · 2026Trial
- Risk Factors for Low CD4+ Count Recovery Despite Viral Suppression Among Participants Initiating Antiretroviral Treatment With CD4+ Counts > 500 Cells/mm3: Findings From the Strategic Timing of AntiRetroviral Therapy (START) Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Multiphenotype association study of patients randomized to initiate antiretroviral regimens in AIDS Clinical Trials Group protocol A5202.Pharmacogenetics and genomics · 2017Trial
- Maraviroc Intensification of cART in Patients with Suboptimal Immunological Recovery: A 48-Week, Placebo-Controlled Randomized Trial.PloS one · 2015Trial
- Trial
- Trial
- Efficacy of a clinical decision-support system in an HIV practice: a randomized trial.Annals of internal medicine · 2012Trial
- Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2010Trial
- Enhanced T cell recovery in HIV-1-infected adults through IL-7 treatment.The Journal of clinical investigation · 2009Trial
- Excessive reactive oxygen species attenuated IL-17 production in CD161Cell communication and signaling : CCS · 2026Article
- Immune cell subset profiling and metabolic dysregulation define the divergent immune microenvironments in HIV immunological non-responders.Clinical and translational medicine · 2025Article
- Long-Term Health-Related Quality of Life in People Living with HIV Who Present to Care with AIDS or Severe Immunodeficiency: The CoRIS AIDS Survivors Study.AIDS and behavior · 2025Article
- HIV-1 inhibits IFITM3 expression to promote the infection of megakaryocytes.Journal of molecular cell biology · 2025Article
- Investigation of Causal Effects of Protein Biomarkers on Cardiovascular Disease in Persons With HIV.The Journal of infectious diseases · 2023Article
- Proteomic investigation and biomarker identification of lung and spleen deficiency syndrome in HIV/AIDS immunological nonresponders.Journal of thoracic disease · 2023Article
- Identification of Potential Diagnostic Genes of HIV-Infected Immunological Non-Responders on Bioinformatics Analysis.Journal of inflammation research · 2023Article
- Determinants of suboptimal immune recovery among a Chinese Yi ethnicity population with sustained HIV suppression.BMC infectious diseases · 2022Article
- Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal.PloS one · 2022Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundLow CD4+ increases risk for both AIDS- and non-AIDS-related morbidity and mortality. The magnitude of CD4+ recovery early after initial antiretroviral therapy (ART) is important in the ultimate duration of immune depletion.
methodsWe examined CD4+ recovery among 850 participants in the Community Program for Clinical Research on AIDS Flexible Initial Retrovirus Suppressive Therapies study with virologic suppression (ie, achieved an HIV RNA level <400 copies/mL) with 8 months of initial ART and determined subsequent risk for AIDS, non-AIDS diseases (non-AIDS cancers and cardiovascular, end-stage renal, and liver diseases), or death using Cox regression during a median 5-year follow-up.
resultsMean pretreatment CD4+ was 221 cells/microL; 18% (n = 149) had a poor CD4+ recovery (<50 cells/microL) after 8 months of effective ART, resulting in lower CD4+ over 5 years. Older age (hazard ratio 1.34/10 yrs, P = 0.003) and lower screening HIV RNA (hazard ratio 0.65 per log10 copies/mL higher, P = 0.001), but not screening CD4+, were associated with a poor CD4+ recovery. After 8 months of effective ART, 30 patients experienced the composite outcome of AIDS, non-AIDS, or death among participants with a poor CD4+ recovery (rate = 5.8/100 person-years) and 74 patients among those with an adequate recovery (>or=50 cells/muL; rate = 2.7/100 person-years) (adjusted hazard ratio = 2.24, P < 0.001). The risk of this composite outcome associated with a poor CD4+ recovery declined when ART was initiated at higher CD4+ counts (P < 0.01).
conclusionsImpaired immune recovery, despite effective ART, results in longer time spent at low CD4+, thereby increasing risk for a broad category of HIV-related morbidity and mortality conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.