Risk factors for discordant immune response among HIV-infected patients initiating antiretroviral therapy: A retrospective cohort study
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Risk factors for discordant immune response among HIV-infected patients initiating antiretroviral therapy: A retrospective cohort study | |
| Creator | Muzah, B P Takuva, S Maskew, M Delany-Moretlwe, S | |
| Description |
Background. The therapeutic goal of antiretroviral therapy (ART) is sustained immune recovery and viral suppression. However, some patients experience poor CD4 cell count responses despite achieving viral suppression. Such discordant immune responses have been associated with poor clinical outcomes. Objective. We aimed to determine the prevalence of discordant immune response and explore associated factors in a retrospective cohort of patients attending 2 large public sector clinics, during the 6 months following ART initiation. Methods. Data were analysed from 810 HIV-infected adults initiated on first-line ART at 2 clinics in Johannesburg, between 1 November 2008 and 31 December 2009. Multivariate logistic regression models were used to estimate adjusted odds ratios (AORs) to determine associations between discordant immune response and clinical and demographic factors. Results. At ART initiation, 65% (n=592) of participants were female, with a mean age of 38.5 years. Median baseline CD4 cell count was 155 cells/mm3, 70% (n=645) of patients had a haemoglobin level >11 g/dl and 88% (n=803) were initiated on stavudine-lamivudine-efavirenz/nevirapine (D4T-3TC-EFV/NVP). Six months after ART initiation, 24% (n=220) of patients had a discordant immune response and 7% (n=67) a discordant virological response. On multivariate analysis, baseline CD cell count ≥200 cells/mm3 (AOR 3.02; 95% confidence interval (CI) 2.08 - 4.38; p |
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| Publisher | AOSIS | |
| Date | 2012-10-04 | |
| Identifier | 10.4102/sajhivmed.v13i4.110 | |
| Source | Southern African Journal of HIV Medicine; Vol 13, No 4 (2012); 168 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/110/178
https://sajhivmed.org.za/index.php/hivmed/article/view/110/177
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