Observational studyAIDS (London, England)2018
CD4+ cell count recovery following initiation of HIV antiretroviral therapy in older childhood and adolescence.
Observational study in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Immune reconstitution efficacy and associated risk factors for immunological non-response in people living with HIV during long-term antiretroviral therapy: a single-center retrospective cohort study at a tertiary care hospital in China.Frontiers in immunology · 2026Article
- Patterns and Cofactors of Polyfunctional Mycobacteria-Specific T-Cell Response Restoration Following 6-Month Antiretroviral Treatment in Children With HIV.The Journal of infectious diseases · 2025Article
- Immunovirological status in people with perinatal and adult-acquired HIV-1 infection: a multi-cohort analysis from France.The Lancet regional health. Europe · 2024Article
- Clinical outcomes and risk factors for immune recovery and all-cause mortality in Latin Americans living with HIV with virological success: a retrospective cohort study.Journal of the International AIDS Society · 2024Article
- Delivery of index-linked HIV testing for children: learnings from a qualitative process evaluation of the B-GAP study in Zimbabwe.BMC infectious diseases · 2023Article
- Evaluation of Clinical Biomarkers Related to CD4 Recovery in HIV-Infected Patients-5-Year Observation.Viruses · 2022Article
- Quantification of CD4 Recovery in Early-Treated Infants Living With HIV.Journal of acquired immune deficiency syndromes (1999) · 2022Article
- Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis.Journal of the International AIDS Society · 2022Article
- Article
- Outcomes of HIV Positive Children and Adolescents Initiated on Antiretroviral Treatment in Nigeria (2007-2016).Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo investigate CD4 cell count recovery following ART initiation in perinatally HIV-infected children diagnosed in later childhood.
designObservational prospective cohort study of newly diagnosed children aged 6-15 in Harare, Zimbabwe.
methodsParticipants were enrolled into a cohort at seven primary healthcare clinics between January 2013 and January 2015. ART was initiated according to national guidelines and CD4 cell counts were performed 6-monthly over 18 months. The relationship between CD4 cell count and time on ART was investigated using regression analysis with fixed (population) and random (individual) effects, and age at ART initiation as a covariate.
resultsOf the 307 participants who initiated ART, the median age at initiation was 11.7 years (interquartile range 9.6-13.8). The addition of an individual intercept and slope as random effects significantly improved the model fit compared with a fixed effects-only model. CD4 response (using a square-root transformation) was best modelled using a two-knot linear spline, with significant effects of time on ART and age at ART initiation. Younger children had a higher CD4 cell count at ART initiation (-17.9 cells/μl per year of age), an accelerated increase during the first 3 months on ART (-38.9 cells/μl per year of age at day 84), and a sustained higher CD4 cell count.
conclusionEarlier ART initiation in older children is associated with accelerated CD4 cell count recovery and lasting immune reconstitution. Our findings support WHO guidance recommending ART initiation in all children, irrespective of disease stage and CD4 cell count.
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