ArticleBMC infectious diseases2012
Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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
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Who cites it
5 citing papers in PubMed, 18 citations in OpenAlex.
- Article
- Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil: a modeling study.BMC public health · 2023Article
- Clinical and Economic Impact of Ibalizumab for People With Multidrug-Resistant HIV in the United States.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Cost-effectiveness of malaria preventive treatment for HIV-infected pregnant women in sub-Saharan Africa.Malaria journal · 2017Article
- Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Article
Corrections and comments
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Authors and funding
20 authors at 13 institutions in 8 countries.
Funding
Abstract
backgroundChanges in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART.
methodNaïve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART.
results3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/μL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12.
conclusionIn routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.
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