Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal
De Beaudrap, P.; Etard, J.-F.ço.; Diouf, A.; Ndiaye, I.; Guèye, N.èy.F.; Guèye, P.M.é; Sow, P.S.; Mboup, S.; Ndoye, I.; Ecochard, R.é; Eric, D.; Ndoye, I.; Delaporte, E.; Etard, J.F.; Laurent, C.; Taverne, B.; Thierry-Mieg, M.; Bitèye, M.M.; Dieng, A.B.; Diouf, A.; Sarr, A.; Zié, L.; Cilote, V.; Lanièce, I.; Ndiaye, I.; Ndir, A.; Ndour, C.T.; Senghor, C.S.; Sow, P.S.; Basty Fall, M.; Dia Badiane, N.M.; Diakhaté, N.; Diallo, M.; Diouf, L.M.; Ngom Guèye, N.F.; Ba Fall, K.; Guèye, P.M.;
American Journal of Tropical Medicine and Hygiene 80(6): 1047-1053
2009
ISSN/ISBN: 1476-1645 PMID: 19478274 Document Number: 206153
To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm3 (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was approximately 421 cells/mm3 (95% CI = 390; 454) in patients with < 200 cells/mm3 at baseline and approximately 500 cells/mm3 in patients with > 200 cells/mm3. The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm3 at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment.