ArticlePloS one2019
CD4 count recovery and associated factors among individuals enrolled in the South African antiretroviral therapy programme: An analysis of national laboratory based data.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Five-Year Immune Recovery After ART Initiation Among PLWH Aged ≥15 Years with Baseline Immunosuppression - China, 2013-2024.China CDC weekly · 2026Article
- Cumulative effect of cotrimoxazole, isoniazid and opportunistic infection prophylaxis on CD4 response among people living with HIV on first-line ART in Ari Zone, Southern Ethiopia.AIDS research and therapy · 2026Article
- Factors mediating and associated with immunological response in women living with HIV in Sweden: A nationwide register-based study.HIV medicine · 2025Article
- A Multistate Continuous Time-Inhomogeneous Markov Model for Assessing the CD4 Count Dynamics of HIV/AIDS Patients Undergoing Antiretroviral Therapy in KwaZulu-Natal, South Africa.International journal of environmental research and public health · 2025Article
- Record linkage without patient identifiers: Proof of concept using data from South Africa's national HIV program.PLOS global public health · 2025Article
- Article
- Characteristics and influencing factors of immunological non-responders in HIV-1-infected patients receiving antiretroviral therapy: a cross-sectional study in Guangxi.Scientific reports · 2024Article
- Alterations of the gut microbiome in HIV infection highlight human anelloviruses as potential predictors of immune recovery.Microbiome · 2024Article
- A comparative assessment of CD4 recovery in a cohort of patients on different HAART regimens in a Nigerian tertiary healthcare facility.African health sciences · 2024Article
- Long-term HIV and tuberculosis outcomes in patients hospitalised with severe cutaneous adverse reactions.Journal of clinical tuberculosis and other mycobacterial diseases · 2023Article
- Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context.BMJ open respiratory research · 2023Article
- 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
- Antiretroviral stewardship in a tertiary academic hospital: The need for a clinical pharmacist.Health SA = SA Gesondheid · 2023Article
- Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis.Journal of the International AIDS Society · 2022Article
- Analysis of the Influencing Factors of Immunological Nonresponders in Wuhan, China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Article
- Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy.Revista da Sociedade Brasileira de Medicina Tropical · 2020Article
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11 authors.
Funding
Abstract
backgroundWe describe CD4 count recovery among HIV positive individuals who initiated antiretroviral therapy (ART) with and without severe immune suppression using complete laboratory data from South Africa's national HIV treatment programme between 2010 and 2014 and discuss implications for CD4 count monitoring.
methodsRetrospective analysis of routinely collected laboratory data from South Africa's National Health Laboratory Service (NHLS). A probabilistic record linkage algorithm was used to create a cohort of HIV positive individuals who initiated ART between 2010 and 2014 based on timing of CD4 count and viral load measurements. A CD4 count < 50 copies/μl at ART initiation was considered severe immunosuppression. A multivariable piecewise mixed-effects linear regression model adjusting for age, gender, year of starting ART, viral suppression in follow up and province was used to predict CD4 counts during follow up.
results1,070,900 individuals had evidence of starting ART during 2010-2014 and met the criteria for inclusion in the cohort -46.6% starting ART with CD4 < 200 cells/μl and 10.1% with CD4 < 50 cells/ μl. For individuals with CD4 counts < 200 cells/μl, predicted CD4 counts > 200 cells/μl, >350 cells/μl and >500 cells/μl corresponded with mean follow up durations of 1.5 years (standard deviation [s.d] 1.1), 1.9years (s.d 1.2) and 2.1 years (s.d 1.3 years). For those with CD4 counts < 50 cells/μl, predicted CD4 count above these threshold corresponded with mean follow up durations of 2.5 years (s.d 0.9 years), 4.4 years (s.d 0.4 years) and 5.0 years (s.d 0.1years) for recovery to the same thresholds. CD4 count recovery varied mostly with duration on ART, CD4 count at the start of ART and gender.
conclusionFor individuals starting with ART with severe immunosuppression, CD4 recovery to 200cells/μl did not occur or took longer than 12 month for significant proportions. CD4 monitoring and interventions recommended for advanced HIV disease should continue until full recovery.
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