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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] C Smith, C Sabin, F Lampe, S Madge, M Youle, A Cozzi-Lepri, H Gumley, M Johnson, A Phillips
Royal Free and University College Medical School, London
BHIVA Conf 2002 Apr 19-21;8:O23
OBJECTIVES: To study the long-term immune response to HAART in previously therapy-naïve patients whose viral load levels remain below 500 copies/mL for prolonged periods of time.
METHODS: Patients whose viral load level reached and remained <500 copies/mL after starting HAART were included. Changes in CD4 counts were analysed using mixed-effects models, with the slope allowed to change at 1, 12 and 24 months after HAART. The correlation between changes in CD4, CD4% and CD8 was assessed.
RESULTS: 187 patients were followed for a median of 2.23 (0.82-4.47) years. After an initial rapid increase in the first month after HAART [78 cells/µL per month, 95% confidence interval (65.4, 87.2)], increases in CD4 counts continued but at a less rapid rate (rate of increase 11.9). This increase slowed non-significantly at 1 year after HAART and again at 2 years [change in slope 5.0 (2.2, 7.8), P=0.0005), but CD4 counts continued to increase overall (slope at 2 years 5.1/month). The percentages of patients with an increase in CD4 count in the first, second and third years after HAART were 92%, 84% and 61% respectively. By the end of follow-up, CD4 counts had risen by a median of 285 (range –210, 990) cells/µL and were above 500 cells/µL in 51% of patients. CD4% and CD8 counts had increased by 11% (–15%, 31%) and 11 (–2839, 2596) cells/mL. Changes in CD4 count at 3 years were correlated with changes in CD4% (r=0.53), but not with changes in CD8 counts (r=0.13).
CONCLUSIONS: Although the rate of immune recovery starts to slow after 2 years, CD4 counts continue to rise in most patients and CD4 counts begin to return to levels seen in HIV-negative individuals.
PRESENTING AUTHOR: C Smith
020419
O23
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD