ArticlePloS one2015
Risk of Severe Non AIDS Events Is Increased among Patients Unable to Increase their CD4+ T-Cell Counts >200+/μl Despite Effective HAART.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Discordant Immune Response with Antiretroviral Therapy in HIV-1: A Systematic Review of Clinical Outcomes.PloS one · 2016Pooled it
- Determinants of CD4 count recovery among severely immunosuppressed HIV patients initiated on antiretroviral therapy: a prospective cohort study in KwaZulu-Natal, South Africa.Frontiers in public health · 2026Article
- NK Count and Natural Cytotoxicity in Immune Nonresponders Versus Responders Living With HIV.Journal of medical virology · 2025Article
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- Determinants of long-term survival in late HIV presenters: The prospective PISCIS cohort study.EClinicalMedicine · 2022Article
- Variation in blood microbial lipopolysaccharide (LPS) contributes to immune reconstitution in response to suppressive antiretroviral therapy in HIV.EBioMedicine · 2022Article
- Clinical factors and outcomes associated with immune non-response among virally suppressed adults with HIV from Africa and the United States.Scientific reports · 2022Article
- CD56International journal of general medicine · 2022Article
- Immunological and virological discordance among people living with HIV on highly active antiretroviral therapy in Tigray, Northern Ethiopia.BMC infectious diseases · 2021Article
- A link between IL-23 and anti-CD4 autoantibody production in antiretroviral-treated HIV-infected individuals.Journal of virology · 2021Article
- Activation and gut-homing of peripheral T cells in HIV immunologic non-responders despite long term viral suppression.PloS one · 2021Article
- Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018.PloS one · 2021Article
- Substantial gap in primary care: older adults with HIV presenting late to care.BMC geriatrics · 2020Article
- Determinants of suboptimal CD4Journal of the International AIDS Society · 2020Article
- Calcaneal Quantitative Ultrasonography and Urinary Retinol-Binding Protein in Antiretroviral-Treated Patients With Human Immunodeficiency Virus in Uganda: A Pilot Study.The Journal of infectious diseases · 2020Article
- Elderly HIV-positive women: A gender-based analysis from the Multicenter Italian "GEPPO" Cohort.PloS one · 2019Article
- Article
- Article
- Long-term clinical, immunological and virological outcomes of patients on antiretroviral therapy in southern Myanmar.PloS one · 2018Article
- Trends in CD4 cell count response to first-line antiretroviral treatment in HIV-positive patients from Asia, 2003-2013: TREAT Asia HIV Observational Database Low Intensity Transfer.International journal of STD & AIDS · 2017Article
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Authors and funding
14 authors at 10 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmunological non-response (INR) despite virological suppression is associated with AIDS-defining events/death (ADE). Little is known about its association with serious non-AIDS-defining events (nADE).
methodsPatients highly-active antiretroviral therapy (HAART) with <200 CD4+/μl and achieving HIV-RNA <50 copies/ml within 12 (±3) months were categorized as INR if CD4+ T-cell count at year 1 was <200/μl. Predictors of nADE (malignancies, severe infections, renal failure--ie, estimated glomerular filtration rate <30 ml/min, cardiovascular events and liver decompensation) were assessed using multivariable Cox models. Follow-up was right-censored in case of HAART discontinuation or confirmed HIV-RNA>50.
results1221 patients were observed for a median of 3 (IQR: 1.3-6.1) years. Pre-HAART CD4+ were 77/μl (IQR: 28-142) and 56% of patients had experienced an ADE. After 1 year, CD4+ increased to 286 (IQR: 197-387), but 26.1% of patients were INR. Thereafter, 86 nADE (30.2% malignancies, 27.9% infectious, 17.4% renal, 17.4% cardiovascular, 7% hepatic) were observed, accounting for an incidence of 1.83 events (95%CI: 1.73-2.61) per 100 PYFU. After adjusting for measurable confounders, INR had a significantly greater risk of nADE (HR 1.65; 95%CI: 1.06-2.56). Older age (per year, HR 1.03; 95%CI: 1.01-1.05), hepatitis C co-infection (HR 2.09; 95%CI: 1.19-3.7), a history of previous nADE (HR 2.16; 95%CI: 1.06-4.4) and the occurrence of ADE during the follow-up (HR 2.2; 95%CI: 1.15-4.21) were other independent predictors of newly diagnosed nADE.
conclusionsPatients failing to restore CD4+ to >200 cells/μl run a greater risk of serious nADE, which is intertwined or predicted by AIDS progression. Improved management of this fragile population and innovative therapy able to induce immune-reconstitution are urgently needed. Also, our results strengthen the importance of earlier diagnosis and HAART introduction.
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