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CD4+ T-cell percentage is an independent predictor of clinical progression in AIDS-free antiretroviral-naive patients with CD4+ T-cell counts >200 cells/mm3.
Antivir Ther. 2009; 14(3):451-7.AT

Abstract

BACKGROUND

The aim of this study was to evaluate the clinical prognostic value of the CD4+ T-cell percentage (%CD4), the CD4+/CD8+ T-cell ratio or the CD8+ T-cell count, in addition to the CD4+ T-cell count and viral load (VL) in antiretroviral-naive HIV-infected patients with CD4+ T-cell counts >200 cells/mm(3).

METHODS

Antiretroviral-naive patients (n=9,740) who were AIDS-free and had a CD4+ T-cell count >200 cells/mm(3) at their first visit after January 1997 were followed-up until treatment initiation or clinical progression (mean follow-up 17 months and 13,660 person-years). Poisson regression was used for statistical analyses.

RESULTS

Progression to AIDS-defining events (ADEs), serious ADEs and death occurred in 228 patients (crude rate 1.69 per 100 person-years), 105 patients (0.77 per 100 person-years) and 67 patients (0.49 per 100 person-years), respectively. Regarding progression to ADE, the data fit was improved when the model also included the %CD4 (Akaike's information criteria [AIC] 2,049) and, to a lesser extent, the CD4+/CD8+ T-cell ratio (AIC 2,053), in addition to CD4+ T-cell count and VL (AIC 2,056). After adjustment for VL and baseline characteristics, patients with CD4+ T-cell counts of 350-500 cells/mm(3) and %CD4<15% had an estimated incidence of ADE of 3 per 100 person-years, similar to that in patients with CD4+ T-cell counts of 200-350 cells/mm(3) and %CD4>15%. The %CD4 was also significantly associated with the risk of serious ADE. By contrast, %CD4, CD4+/CD8+ T-cell ratio or CD8+ T-cell count had no additional prognostic value for the risk of death.

CONCLUSIONS

In antiretroviral-naive HIV-infected patients with CD4+ T-cell counts >200 cells/mm(3), the %CD4 was predictive of the risk of clinical progression independently of CD4+ T-cell count and VL.

Authors+Show Affiliations

INSERM U943, Paris, France. mguiguet@ccde.chups.jussieu.frNo affiliation info availableNo affiliation info availableNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

19474479

Citation

Guiguet, Marguerite, et al. "CD4+ T-cell Percentage Is an Independent Predictor of Clinical Progression in AIDS-free Antiretroviral-naive Patients With CD4+ T-cell Counts >200 Cells/mm3." Antiviral Therapy, vol. 14, no. 3, 2009, pp. 451-7.
Guiguet M, Kendjo E, Carcelain G, et al. CD4+ T-cell percentage is an independent predictor of clinical progression in AIDS-free antiretroviral-naive patients with CD4+ T-cell counts >200 cells/mm3. Antivir Ther. 2009;14(3):451-7.
Guiguet, M., Kendjo, E., Carcelain, G., Abgrall, S., Mary-Krause, M., Tattevin, P., Yazdanpanah, Y., Costagliola, D., & Duval, X. (2009). CD4+ T-cell percentage is an independent predictor of clinical progression in AIDS-free antiretroviral-naive patients with CD4+ T-cell counts >200 cells/mm3. Antiviral Therapy, 14(3), 451-7.
Guiguet M, et al. CD4+ T-cell Percentage Is an Independent Predictor of Clinical Progression in AIDS-free Antiretroviral-naive Patients With CD4+ T-cell Counts >200 Cells/mm3. Antivir Ther. 2009;14(3):451-7. PubMed PMID: 19474479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CD4+ T-cell percentage is an independent predictor of clinical progression in AIDS-free antiretroviral-naive patients with CD4+ T-cell counts >200 cells/mm3. AU - Guiguet,Marguerite, AU - Kendjo,Eric, AU - Carcelain,Guislaine, AU - Abgrall,Sophie, AU - Mary-Krause,Murielle, AU - Tattevin,Pierre, AU - Yazdanpanah,Yazdan, AU - Costagliola,Dominique, AU - Duval,Xavier, AU - ,, PY - 2009/5/29/entrez PY - 2009/5/29/pubmed PY - 2009/7/31/medline SP - 451 EP - 7 JF - Antiviral therapy JO - Antivir Ther VL - 14 IS - 3 N2 - BACKGROUND: The aim of this study was to evaluate the clinical prognostic value of the CD4+ T-cell percentage (%CD4), the CD4+/CD8+ T-cell ratio or the CD8+ T-cell count, in addition to the CD4+ T-cell count and viral load (VL) in antiretroviral-naive HIV-infected patients with CD4+ T-cell counts >200 cells/mm(3). METHODS: Antiretroviral-naive patients (n=9,740) who were AIDS-free and had a CD4+ T-cell count >200 cells/mm(3) at their first visit after January 1997 were followed-up until treatment initiation or clinical progression (mean follow-up 17 months and 13,660 person-years). Poisson regression was used for statistical analyses. RESULTS: Progression to AIDS-defining events (ADEs), serious ADEs and death occurred in 228 patients (crude rate 1.69 per 100 person-years), 105 patients (0.77 per 100 person-years) and 67 patients (0.49 per 100 person-years), respectively. Regarding progression to ADE, the data fit was improved when the model also included the %CD4 (Akaike's information criteria [AIC] 2,049) and, to a lesser extent, the CD4+/CD8+ T-cell ratio (AIC 2,053), in addition to CD4+ T-cell count and VL (AIC 2,056). After adjustment for VL and baseline characteristics, patients with CD4+ T-cell counts of 350-500 cells/mm(3) and %CD4<15% had an estimated incidence of ADE of 3 per 100 person-years, similar to that in patients with CD4+ T-cell counts of 200-350 cells/mm(3) and %CD4>15%. The %CD4 was also significantly associated with the risk of serious ADE. By contrast, %CD4, CD4+/CD8+ T-cell ratio or CD8+ T-cell count had no additional prognostic value for the risk of death. CONCLUSIONS: In antiretroviral-naive HIV-infected patients with CD4+ T-cell counts >200 cells/mm(3), the %CD4 was predictive of the risk of clinical progression independently of CD4+ T-cell count and VL. SN - 1359-6535 UR - https://www.unboundmedicine.com/medline/citation/19474479/CD4+_T_cell_percentage_is_an_independent_predictor_of_clinical_progression_in_AIDS_free_antiretroviral_naive_patients_with_CD4+_T_cell_counts_>200_cells/mm3_ L2 - http://www.diseaseinfosearch.org/result/279 DB - PRIME DP - Unbound Medicine ER -