Trial reportJournal of acquired immune deficiency syndromes (1999)2019
Risk Factors for Low CD4+ Count Recovery Despite Viral Suppression Among Participants Initiating Antiretroviral Treatment With CD4+ Counts > 500 Cells/mm3: Findings From the Strategic Timing of AntiRetroviral Therapy (START) Trial.
Trial report in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Pooled it
- Adjuvant roles of interleukin-7 in enhancing T cell recovery during antiretroviral therapy for individuals with HIV: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Benefits and Risks of Rapid Initiation of Antiretroviral Therapy: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2022Pooled it
- Long-term immune recovery under continuous antiretroviral therapy (ART) among ART-naive people living with HIV in two cohorts in Germany.Infection · 2026Article
- Defining and Predicting HIV Immunological Non-Response: A Multi-Definition Analysis from an Indonesian Cohort.Viruses · 2025Article
- Impact of Anti-CD4 Autoantibodies on Immune Reconstitution in People With Advanced HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Predicting the immunological nonresponse to antiretroviral therapy in people living with HIV: a machine learning-based multicenter large-scale study.Frontiers in cellular and infection microbiology · 2025Article
- Population-Specific Predictors of Immunologic Reconstitution Following Initiation of Combined Antiretroviral Therapy in Children: A Retrospective Observational Study from a 15-Year Cohort of HIV-Positive Children and Adolescents in Eritrea.HIV/AIDS (Auckland, N.Z.) · 2024Article
- Recent advances in poor HIV immune reconstitution: what will the future look like?Frontiers in microbiology · 2023Review
- Article
- Immune reconstruction effectiveness of combination antiretroviral therapy for HIV-1 CRF01_AE cluster 1 and 2 infected individuals.Emerging microbes & infections · 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
- CD4+ cell count recovery after initiation of antiretroviral therapy in HIV-infected Ethiopian adults.PloS one · 2022Article
- The accumulation of plasma acylcarnitines are associated with poor immune recovery in HIV-infected individuals.BMC infectious diseases · 2021Article
- Patterns of Antiretroviral Therapy Use and Immunologic Profiles at Enrollment in the REPRIEVE Trial.The Journal of infectious diseases · 2020 · on this mapArticle
- Enrollment Length, Service Category, and HIV Health Outcomes Among Low-Income HIV-Positive Persons Newly Enrolled in a Housing Program, New York City, 2014-2017.American journal of public health · 2020Article
- Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non-responders.Journal of leukocyte biology · 2020Review
- CD4 testing after initiation of antiretroviral therapy: Analysis of routine data from the South African HIV programme.Southern African journal of HIV medicine · 2020Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundLow CD4 recovery among HIV-positive individuals who achieve virologic suppression is common but has not been studied among individuals initiating treatment at CD4 counts of >500 cells/mm.
settingUnited States, Africa, Asia, Europe and Israel, Australia, Latin America.
methodsAmong participants randomized to immediate antiretroviral therapy (ART) in the Strategic Timing of AntiRetroviral Therapy trial, low CD4 recovery was defined as a CD4 increase of <50 cells/mm from baseline after 8 months despite viral load of ≤200 copies/mL. Risk factors for low recovery were investigated with logistic regression.
resultsLow CD4 recovery was observed in 39.7% of participants. Male sex [odds ratio (OR), 1.53; P = 0.007], lower screening CD4 cell counts (OR, 1.09 per 100 fewer cells/mm; P = 0.004), higher baseline CD8 cell counts (OR, 1.05 per 100 more cells/mm; P < 0.001), and lower HIV RNA levels (OR, 1.93 per log10 decrease; P < 0.001) were associated with low CD4 recovery. D-dimer had a quadratic association with low CD4 recovery, with lowest odds occurring at 0.32 μg/mL. At lower HIV RNA levels, the odds of low CD4 recovery were elevated across the levels of screening CD4 count; but at higher HIV RNA levels, the odds of low CD4 recovery were higher among those with lower vs. higher screening CD4.
conclusionsLow CD4 recovery is frequent among participants starting ART at high CD4 counts. Risk factors include male sex, lower screening CD4 cell counts, higher CD8 cell counts, and lower HIV RNA levels. More follow-up is required to determine the impact of low CD4 recovery on clinical outcomes.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.