Observational studyJournal of acquired immune deficiency syndromes (1999)2016
When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study.
Observational study in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV-positive individuals.Statistics in medicine · 2019Trial
- Comparative effectiveness of alternative times to opioid agonist treatment taper initiation on taper completion and all-cause mortality among people with opioid use disorder: A retrospective population-based target trial emulation study in British Columbia, Canada, 2010-2020.Addiction (Abingdon, England) · 2026Observational
- Human immunodeficiency virus-associated gut microbiome impacts systemic immunodeficiency and susceptibility to opportunistic gut infection.Nature microbiology · 2026Article
- [Comparing the effectiveness of multiple dynamic treatment strategies using target trial emulation].Pravention und Gesundheitsforderung · 2023Article
- Article
- The Future of Causal Inference.American journal of epidemiology · 2022Article
- Comparative Effectiveness of Opioid Tapering or Abrupt Discontinuation vs No Dosage Change for Opioid Overdose or Suicide for Patients Receiving Stable Long-term Opioid Therapy.JAMA network open · 2022Article
- A comparative analysis and review of how national guidelines for chronic disease monitoring are made in low- and middle-income compared to high-income countries.Journal of global health · 2021Article
- Adherence to antiretroviral therapy among HIV infected pregnant women in public health sectors: a pilot of Chilenje level one Hospital Lusaka, Zambia.The Pan African medical journal · 2020Article
- Associations between baseline characteristics, CD4 cell count response and virological failure on first-line efavirenz + tenofovir + emtricitabine for HIV.Journal of virus eradication · 2019Article
- Effectiveness of Transmitted Drug Resistance Testing Before Initiation of Antiretroviral Therapy in HIV-Positive Individuals.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Is it Safe and Cost Saving to Defer the CD4+ Cell Count Monitoring in Stable Patients on Art with More than 350 or 500 cells/μl?Mediterranean journal of hematology and infectious diseases · 2019Article
- Observational
Corrections and comments
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Authors and funding
39 authors.
Funding
Abstract
objectiveTo illustrate an approach to compare CD4 cell count and HIV-RNA monitoring strategies in HIV-positive individuals on antiretroviral therapy (ART).
designProspective studies of HIV-positive individuals in Europe and the USA in the HIV-CAUSAL Collaboration and The Center for AIDS Research Network of Integrated Clinical Systems.
methodsAntiretroviral-naive individuals who initiated ART and became virologically suppressed within 12 months were followed from the date of suppression. We compared 3 CD4 cell count and HIV-RNA monitoring strategies: once every (1) 3 ± 1 months, (2) 6 ± 1 months, and (3) 9-12 ± 1 months. We used inverse-probability weighted models to compare these strategies with respect to clinical, immunologic, and virologic outcomes.
resultsIn 39,029 eligible individuals, there were 265 deaths and 690 AIDS-defining illnesses or deaths. Compared with the 3-month strategy, the mortality hazard ratios (95% CIs) were 0.86 (0.42 to 1.78) for the 6 months and 0.82 (0.46 to 1.47) for the 9-12 month strategy. The respective 18-month risk ratios (95% CIs) of virologic failure (RNA >200) were 0.74 (0.46 to 1.19) and 2.35 (1.56 to 3.54) and 18-month mean CD4 differences (95% CIs) were -5.3 (-18.6 to 7.9) and -31.7 (-52.0 to -11.3). The estimates for the 2-year risk of AIDS-defining illness or death were similar across strategies.
conclusionsOur findings suggest that monitoring frequency of virologically suppressed individuals can be decreased from every 3 months to every 6, 9, or 12 months with respect to clinical outcomes. Because effects of different monitoring strategies could take years to materialize, longer follow-up is needed to fully evaluate this question.
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