Rate of AIDS diseases or death in HIV-infected antiretroviral therapy-naive individuals with high CD4 cell count

Andrew N. Phillips, Brian Gazzard, Richard Gilson, Philippa Easterbrook, Margaret Johnson, John Walsh, Clifford Leen, Martin Fisher, Chloe Orkin, Jane Anderson, Deenan Pillay, Valerie Delpech, Caroline Sabin, Achim Schwenk, David Dunn, Mark Gompels, Teresa Hill, Kholoud Porter, Abdel Babiker

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82 Citations (Scopus)

Abstract

OBJECTIVE: To assess the absolute rate of AIDS and death in antiretroviral therapy (ART)-naive patients with a high CD4 cell count. Such information would be helpful in the design of a trial investigating early initiation of ART. DESIGN: Analysis of data from an ongoing HIV cohort study. METHODS: The rate of (severe) AIDS or death and death alone was evaluated in ART-naive patients according to the current CD4 cell count, focusing on CD4 cell counts ≥ 350 cells/μl among patients in the UK CHIC Study. RESULTS: In a total of 30 313 person-years of follow-up, there were 1557 AIDS or death events. The rate of AIDS or death in persons with most recent CD4 cell count 350-499, 500-649 and > 650 cells/μl was 2.49, 1.54 and 0.96 per 100 person-years, respectively. The rate ratio for those with CD4 cell count 500-649 cells/μl compared with those with CD4 cell count ≥ 650 cells/μl was 1.55 [95% confidence interval (CI), 1.11-2.17; P = 0.01]. In a Poisson regression model based on person years with CD4 cell count ≥ 350 cells/μl, there was a strong effect of CD4 cell count on rate of AIDS or death (rate ratio, 0.84; 95% CI, 0.76-0.93; P = 0.001), independent of viral load and age. CONCLUSIONS: The trend of decreasing rate of AIDS and death with higher CD4 cell count is present throughout the CD4 cell count ≥ 350 cells/μl range in ART-naive people.

Original languageEnglish
Pages (from-to)1717-1721
Number of pages5
JournalAIDS
Volume21
Issue number13
DOIs
Publication statusPublished - Aug 2007

Keywords

  • AIDS
  • CD4 cell count
  • Cohort study
  • Death
  • Rate
  • Risk
  • Serious AIDS

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