ArticlePloS one2016
Impact of Age and Sex on CD4+ Cell Count Trajectories following Treatment Initiation: An Analysis of the Tanzanian HIV Treatment Database.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 26 citations in OpenAlex.
- 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
- Fast standard error estimation for joint models of longitudinal and time-to-event data based on stochastic EM algorithms.Biostatistics (Oxford, England) · 2025Article
- Evaluation of bone mineral density and its influencing factors in patients infected with HIV under antiretroviral therapy.BMC infectious diseases · 2025Article
- Evolution of CD4 T-Cell Count With Age in a Cohort of Young People Growing Up With Perinatally Acquired Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Empowering adolescents living with perinatally-acquired HIV: tailored CD4+ count assessment for optimized care, the EDCTP READY-study.Frontiers in medicine · 2024Article
- Common Risk Factors for CD4 Cell Count and Hemoglobin Level among Female Adult HIV-Positive Patients: A Retrospective Longitudinal Study.Journal of tropical medicine · 2024Article
- Leveraging CD4 Cell Count at Entry Into Care to Monitor Success of Human Immunodeficiency Virus Prevention, Treatment, and Public Health Programming in the Greater St Louis Area Between 2017 and 2020.Open forum infectious diseases · 2023Article
- Infection with soil-transmitted helminths and their impact on coinfections.Frontiers in parasitology · 2023Review
- Combining CD4 count, CD8 count and CD4/CD8 ratio to predict risk of mortality among HIV-positive adults after therapy: a group-based multi-trajectory analysis.Frontiers in immunology · 2023Article
- The Body Fat Percentage Rather Than the BMI Is Associated with the CD4 Count among HIV Positive Japanese Individuals.Nutrients · 2022Article
- Factors Associated with Baseline CD4 Cell Counts and Advanced HIV Disease among Male and Female HIV-Positive Patients in Iran: A Retrospective Cohort Study.Journal of tropical medicine · 2022Article
- Article
- Peripheral neuropathy in patients with human immunodeficiency viral infection at a tertiary hospital in Ghana.Journal of neurovirology · 2019Article
- HIV Disease Progression Among Antiretroviral Therapy Patients in Zimbabwe: A Multistate Markov Model.Frontiers in public health · 2019Article
- Article
- Drug Use is Associated with Anti-CD4 IgG-mediated CD4+ T Cell Death and Poor CD4+ T Cell Recovery in Viral-suppressive HIV-infected Individuals Under Antiretroviral Therapy.Current HIV research · 2018Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 6 institutions in 4 countries.
Funding
Abstract
objectiveNew guidelines recommend that all HIV-infected individuals initiate antiretroviral treatment (ART) immediately following diagnosis. This study describes how immune reconstitution varies by gender and age to help identify poorly reconstituting subgroups and inform targeted testing initiatives.
designLongitudinal data from the outpatient monitoring system of the National AIDS Control Program in Tanzania.
methodsAn asymptotic nonlinear mixed effects model was fit to post-treatment CD4+ cell count trajectories, allowing for fixed effects of age and sex, and an age by sex interaction.
resultsAcross 220,544 clinic visits from 32,069 HIV-infected patients, age- and sex-specific average CD4+ cell count at ART initiation ranged from 83-136 cells/mm3, long term asymptotic CD4+ cell count ranged from 301-389 cells/mm3, and time to half of maximal CD4+ reconstitution ranged from 3.57-5.68 months. CD4+ cell count at ART initiation and asymptotic CD4+ cell count were 1.28 (95% CI: 1.18-1.40) and 1.25 (95% CI: 1.20-1.31) times higher, respectively, for females compared to males in the youngest age group (19-29 years). Older patients started treatment at higher CD4+ counts but experienced slower CD4+ recovery than younger adults. Treatment initiation at greater CD4+ cell counts was correlated with greater asymptotic CD4+ cell counts within all sex and age groups.
conclusionOlder adults should initiate care early in disease progression because total immune reconstitution potential and rate of reconstitution appears to decrease with age. Targeted HIV testing and care linkage remains crucial for patient populations who tend to initiate treatment at lower CD4+ cell counts, including males and younger adults.
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