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CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts >350 lymphocytes/mm3.
J Infect Dis. 2005 Sep 15; 192(6):950-7.JI

Abstract

BACKGROUND

The optimal timing of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients with > or = 200 absolute CD4 lymphocytes/mm3 is unknown. CD4 lymphocyte percentage could add prognostic information.

METHODS

Persons who initiated HAART between 1 January 1998 and 1 January 2003, received > or = 30 days of therapy, and had baseline CD4 lymphocyte data available were included in the study. The log-rank test for time to event and Cox proportional hazards models were used to determine predictors of a new acquired immunodeficiency syndrome-defining illness or death.

RESULTS

A total of 788 patients met the inclusion criteria. At baseline, subjects had a median of 225 CD4 lymphocytes/mm3 and 17% CD4 lymphocytes. Subjects with < 17% CD4 lymphocytes had earlier disease progression, compared with subjects with > or = 17%, both in the entire cohort (P<.0001) and of those subjects with > 350 absolute CD4 lymphocytes/mm3 at baseline (P=.03). CD4 lymphocyte percentage < 17% was the strongest predictor of disease progression among subjects in this latter group (hazard ratio, 3.57; P=.045).

CONCLUSIONS

In this cohort, CD4 lymphocyte percentage predicted disease progression in HIV-infected subjects who initiated therapy with > 350 CD4 lymphocytes/mm3. This information may help identify persons who will derive the greatest benefit from initiation of HAART.

Authors+Show Affiliations

Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee 37203, USA. todd.hulgan@vanderbilt.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16107946

Citation

Hulgan, Todd, et al. "CD4 Lymphocyte Percentage Predicts Disease Progression in HIV-infected Patients Initiating Highly Active Antiretroviral Therapy With CD4 Lymphocyte Counts >350 Lymphocytes/mm3." The Journal of Infectious Diseases, vol. 192, no. 6, 2005, pp. 950-7.
Hulgan T, Raffanti S, Kheshti A, et al. CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts >350 lymphocytes/mm3. J Infect Dis. 2005;192(6):950-7.
Hulgan, T., Raffanti, S., Kheshti, A., Blackwell, R. B., Rebeiro, P. F., Barkanic, G., Ritz, B., & Sterling, T. R. (2005). CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts >350 lymphocytes/mm3. The Journal of Infectious Diseases, 192(6), 950-7.
Hulgan T, et al. CD4 Lymphocyte Percentage Predicts Disease Progression in HIV-infected Patients Initiating Highly Active Antiretroviral Therapy With CD4 Lymphocyte Counts >350 Lymphocytes/mm3. J Infect Dis. 2005 Sep 15;192(6):950-7. PubMed PMID: 16107946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts >350 lymphocytes/mm3. AU - Hulgan,Todd, AU - Raffanti,Stephen, AU - Kheshti,Asghar, AU - Blackwell,Robert B, AU - Rebeiro,Peter F, AU - Barkanic,Gema, AU - Ritz,Brandon, AU - Sterling,Timothy R, Y1 - 2005/08/15/ PY - 2004/08/30/received PY - 2005/04/27/accepted PY - 2005/8/19/pubmed PY - 2005/11/9/medline PY - 2005/8/19/entrez SP - 950 EP - 7 JF - The Journal of infectious diseases JO - J Infect Dis VL - 192 IS - 6 N2 - BACKGROUND: The optimal timing of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients with > or = 200 absolute CD4 lymphocytes/mm3 is unknown. CD4 lymphocyte percentage could add prognostic information. METHODS: Persons who initiated HAART between 1 January 1998 and 1 January 2003, received > or = 30 days of therapy, and had baseline CD4 lymphocyte data available were included in the study. The log-rank test for time to event and Cox proportional hazards models were used to determine predictors of a new acquired immunodeficiency syndrome-defining illness or death. RESULTS: A total of 788 patients met the inclusion criteria. At baseline, subjects had a median of 225 CD4 lymphocytes/mm3 and 17% CD4 lymphocytes. Subjects with < 17% CD4 lymphocytes had earlier disease progression, compared with subjects with > or = 17%, both in the entire cohort (P<.0001) and of those subjects with > 350 absolute CD4 lymphocytes/mm3 at baseline (P=.03). CD4 lymphocyte percentage < 17% was the strongest predictor of disease progression among subjects in this latter group (hazard ratio, 3.57; P=.045). CONCLUSIONS: In this cohort, CD4 lymphocyte percentage predicted disease progression in HIV-infected subjects who initiated therapy with > 350 CD4 lymphocytes/mm3. This information may help identify persons who will derive the greatest benefit from initiation of HAART. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/16107946/CD4_lymphocyte_percentage_predicts_disease_progression_in_HIV_infected_patients_initiating_highly_active_antiretroviral_therapy_with_CD4_lymphocyte_counts_>350_lymphocytes/mm3_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/432955 DB - PRIME DP - Unbound Medicine ER -