scholarly journals Safety of monitoring antiretroviral therapy response in HIV-1 infection using CD4+ T cell count at long-term intervals

2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Ingridt Hildegard Vogler ◽  
Daniela Frizon Alfieri ◽  
Heloisa Damazio Bruna Gianjacomo ◽  
Elaine Regina Delicato de Almeida ◽  
Edna Maria Vissoci Reiche
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Sustained Virologic Response ◽  
Virologic Response ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Hiv 1 ◽  
Cd4 T Cell Count

Abstract: The latest Brazilian guideline recommended the reduction of routine CD4+ T cell counts for the monitoring of patients with human immunodeficiency virus type 1 (HIV-1) under combination antiretroviral therapy (cART). The aim of this study was to evaluate the safety of monitoring response to cART in HIV-1 infection using routine viral load at shorter intervals and CD4+ T cell count at longer intervals. CD4+ T cell counts and HIV-1 viral load were evaluated in 1,906 HIV-1-infected patients under cART during a three-year follow-up. Patients were stratified as sustained, non-sustained and non-responders. The proportion of patients who showed a CD4+ T > 350cells/µL at study entry among those with sustained, non-sustained and non-responders to cART and who remained with values above this threshold during follow-up was 94.1%, 81.8% and 71.9%, respectively. HIV-1-infected patients who are sustained virologic responders and have initial CD4+ T cell counts > 350cells/µL showed a higher chance of maintaining the counts of these cells above this threshold during follow-up than those presenting CD4+ T ≤ 350cells/µL (OR = 39.9; 95%CI: 26.5-60.2; p < 0.001). This study showed that HIV-1-infected patients who had sustained virologic response and initial CD4+ T > 350cells/µL were more likely to maintain CD4+ T cell counts above this threshold during the next three-year follow-up. This result underscores that the evaluation of CD4+ T cell counts in longer intervals does not impair the safety of monitoring cART response when routine viral load assessment is performed in HIV-1-infected patients with sustained virologic response.

Distribution of HIV-1 Plasma RNA Viral Load and CD4 + T-Cell Counts Among HIV-Infected Africans Evaluated for Antiretroviral Therapy

2001 ◽  
Vol 28 (1) ◽  
pp. 99-101 ◽  
Author(s):  
John N. Nkengasong ◽  
Marie-Yolande Borget ◽  
Chantal Maurice ◽  
Emmanuel Boateng ◽  
Mireille Kalou ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Plasma Rna ◽  
Hiv 1

scholarly journals Reconstitution of Peripheral T Cells by Tissue-Derived CCR4+ Central Memory Cells Following HIV-1 Antiretroviral Therapy

2016 ◽  
Vol 1 (2) ◽  
pp. 260 ◽  
Author(s):  
Yolanda D. Mahnke ◽  
Kipper Fletez-Brant ◽  
Irini Sereti ◽  
Mario Roederer
Keyword(s):  
T Cells ◽  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cd8 T Cells ◽  
Plasma Viral Load ◽  
Cd4 T Cell ◽  
Cell Numbers ◽  
Cell Counts ◽  
Hiv 1

Background. Highly active antiretroviral therapy induces clinical benefits to HIV-1 infected individuals, which can be striking in those with progressive disease. Improved survival and decreased incidence of opportunistic infections go hand in hand with a suppression of the plasma viral load, an increase in peripheral CD4+ T-cell counts, as well as a reduction in the activation status of both CD4+ and CD8+ T cells.Methods. We investigated T-cell dynamics during ART by polychromatic flow cytometry in total as well as in HIV-1-specific CD4+ and CD8+ T cells. We also measured gene expression by single cell transcriptomics to assess functional state.Results. The cytokine pattern of HIV-specific CD8+ T cells was not altered after ART, though their magnitude decreased significantly as the plasma viral load was suppressed to undetectable levels. Importantly, while CD4+ T cell numbers increased substantially during the first year, the population did not normalize: the increases were largely due to expansion of mucosal-derived CCR4+ CD4+ TCM; transcriptomic analysis revealed that these are not classical Th2-type cells.Conclusion. The apparent long-term normalization of CD4+ T-cell numbers following ART does not comprise a normal balance of functionally distinct cells, but results in a dramatic Th2 shift of the reconstituting immune system.

scholarly journals Distribution of HIV-1 Plasma RNA Viral Load and CD4 + T-Cell Counts Among HIV-Infected Africans Evaluated for Antiretroviral Therapy

2001 ◽  
Vol 28 (1) ◽  
pp. 99-101
Author(s):  
John N. Nkengasong ◽  
Marie-Yolande Borget ◽  
Chantal Maurice ◽  
Emmanuel Boateng ◽  
Mireille Kalou ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Plasma Rna ◽  
Hiv 1

Racial/ethnic differences in CD4 T cell count and viral load at presentation for medical care and in follow-up after HIV-1 infection

AIDS ◽  
2002 ◽  
Vol 16 (13) ◽  
pp. 1832-1834 ◽  
Author(s):  
Susan Swindells ◽  
Daniel G. Cobos ◽  
Nancy Lee ◽  
Elizabeth A. Lien ◽  
Ann P. Fitzgerald ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Medical Care ◽  
Cell Count ◽  
Ethnic Differences ◽  
Cd4 T Cell ◽  
Racial Ethnic ◽  
Hiv 1 ◽  
Cd4 T Cell Count

scholarly journals PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  
Keyword(s):  
South Africa ◽  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Point Of Care ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Kwazulu Natal ◽  
Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

scholarly journals EBV AND HHV-6 CIRCULATING SUBTYPES IN PEOPLE LIVING WITH HIV IN BURKINA FASO, IMPACT ON CD4 T CELL COUNT AND HIV VIRAL LOAD

2017 ◽  
Vol 9 (1) ◽  
pp. 2017049 ◽  
Author(s):  
Lassina TRAORE ◽  
Ouéogo NIKIEMA ◽  
Abdoul Karim OUATTARA ◽  
Tegwindé Rébéca COMPAORE ◽  
Serge Théophile SOUBEIGA ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Study Population ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Cd4 T Cell Count

Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ≥ 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.

The Challenge of HIV-1 Genetic Diversity: Discordant CD4+ T-Cell Count and Viral Load in an Untreated Patient Infected With a Subtype F Strain

2009 ◽  
Vol 52 (5) ◽  
pp. 659-661 ◽  
Author(s):  
Hector Bolivar ◽  
Rebeca Geffin ◽  
Gabriel Manzi ◽  
Margaret A Fischl ◽  
Vera Holzmayer ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Untreated Patient ◽  
Cd4 T Cell ◽  
Hiv 1 ◽  
Cd4 T Cell Count
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