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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">CD4+ T cell recovery during suppression of HIV replication: an international comparison of the immunological efficacy of antiretroviral therapy in North America, Asia and Africa</title><author><name sortKey="Geng, Elvin H" sort="Geng, Elvin H" uniqKey="Geng E" first="Elvin H" last="Geng">Elvin H. Geng</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Neilands, Torsten B" sort="Neilands, Torsten B" uniqKey="Neilands T" first="Torsten B" last="Neilands">Torsten B. Neilands</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thièbaut">Rodolphe Thièbaut</name><affiliation><nlm:aff id="dyu271-AFF1">INSERM U897, Bordeaux University, Bordeaux, France,</nlm:aff></affiliation></author><author><name sortKey="Bosco Bwana, Mwebesa" sort="Bosco Bwana, Mwebesa" uniqKey="Bosco Bwana M" first="Mwebesa" last="Bosco Bwana">Mwebesa Bosco Bwana</name><affiliation><nlm:aff id="dyu271-AFF1">Mbarara University of Science and Technology, Mbarara, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name><affiliation><nlm:aff id="dyu271-AFF1">City University of New York, New York, NY, USA,</nlm:aff></affiliation></author><author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D" last="Moore">Richard D. Moore</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation></author><author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Marcel Zannou, Djimon" sort="Marcel Zannou, Djimon" uniqKey="Marcel Zannou D" first="Djimon" last="Marcel Zannou">Djimon Marcel Zannou</name><affiliation><nlm:aff id="dyu271-AFF1">Centre National Hospitalier Universitaire, Cotonou, Benin,</nlm:aff></affiliation></author><author><name sortKey="Althoff, Keri N" sort="Althoff, Keri N" uniqKey="Althoff K" first="Keri N" last="Althoff">Keri N. Althoff</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation></author><author><name sortKey="Lian Lim, Poh" sort="Lian Lim, Poh" uniqKey="Lian Lim P" first="Poh" last="Lian Lim">Poh Lian Lim</name><affiliation><nlm:aff id="dyu271-AFF1">Institute of Infectious Disease, Tan Tock Seng Hospital, Singapore, Singapore,</nlm:aff></affiliation></author><author><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B" last="Nachega">Jean B. Nachega</name><affiliation><nlm:aff id="dyu271-AFF1">Department of Epidemiology, Infectious Diseases Program, Pittsburgh University, Graduate School of Public Health, Pittsburg, PA, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Department of Medicine & Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Easterbrook, Philippa J" sort="Easterbrook, Philippa J" uniqKey="Easterbrook P" first="Philippa J" last="Easterbrook">Philippa J. Easterbrook</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Kambugu, Andrew" sort="Kambugu, Andrew" uniqKey="Kambugu A" first="Andrew" last="Kambugu">Andrew Kambugu</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Little, Francesca" sort="Little, Francesca" uniqKey="Little F" first="Francesca" last="Little">Francesca Little</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Nakanjako, Damalie" sort="Nakanjako, Damalie" uniqKey="Nakanjako D" first="Damalie" last="Nakanjako">Damalie Nakanjako</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Kiggundu, Valerian" sort="Kiggundu, Valerian" uniqKey="Kiggundu V" first="Valerian" last="Kiggundu">Valerian Kiggundu</name><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Chung Ki Li, Patrick" sort="Chung Ki Li, Patrick" uniqKey="Chung Ki Li P" first="Patrick" last="Chung Ki Li">Patrick Chung Ki Li</name><affiliation><nlm:aff id="dyu271-AFF1">Queen Elizabeth Hospital, Hong Kong, China,</nlm:aff></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R" last="Bangsberg">David R. Bangsberg</name><affiliation><nlm:aff id="dyu271-AFF1">Center for Global Health, Massachusetts General Hospital, Harvard University, Boston, MA, USA,</nlm:aff></affiliation></author><author><name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P" last="Fox">Matthew P. Fox</name><affiliation><nlm:aff id="dyu271-AFF1">Center for Global Health and Development, Boston University, Boston, MA, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Prozesky, Hans W" sort="Prozesky, Hans W" uniqKey="Prozesky H" first="Hans W" last="Prozesky">Hans W. Prozesky</name><affiliation><nlm:aff id="dyu271-AFF1">Division of Infectious Diseases, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W" last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Reynolds, Steven J" sort="Reynolds, Steven J" uniqKey="Reynolds S" first="Steven J" last="Reynolds">Steven J. Reynolds</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">National Institutes of Allergy and Infectious Diseases, Washington DC, USA,</nlm:aff></affiliation></author><author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><affiliation><nlm:aff wicri:cut=" and" id="dyu271-AFF1">University of Bern, Bern, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Yiannoutsos, Constantin T" sort="Yiannoutsos, Constantin T" uniqKey="Yiannoutsos C" first="Constantin T" last="Yiannoutsos">Constantin T. Yiannoutsos</name><affiliation><nlm:aff id="dyu271-AFF1">Indiana University, Indianapolis, IN, USA</nlm:aff></affiliation></author><author><name sortKey="Vittinghoff, Eric V" sort="Vittinghoff, Eric V" uniqKey="Vittinghoff E" first="Eric V" last="Vittinghoff">Eric V. Vittinghoff</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Deeks, Steven G" sort="Deeks, Steven G" uniqKey="Deeks S" first="Steven G" last="Deeks">Steven G. Deeks</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N" last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25859596</idno><idno type="pmc">4339766</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339766</idno><idno type="RBID">PMC:4339766</idno><idno type="doi">10.1093/ije/dyu271</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001690</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001690</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">CD4+ T cell recovery during suppression of HIV replication: an international comparison of the immunological efficacy of antiretroviral therapy in North America, Asia and Africa</title><author><name sortKey="Geng, Elvin H" sort="Geng, Elvin H" uniqKey="Geng E" first="Elvin H" last="Geng">Elvin H. Geng</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Neilands, Torsten B" sort="Neilands, Torsten B" uniqKey="Neilands T" first="Torsten B" last="Neilands">Torsten B. Neilands</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thièbaut">Rodolphe Thièbaut</name><affiliation><nlm:aff id="dyu271-AFF1">INSERM U897, Bordeaux University, Bordeaux, France,</nlm:aff></affiliation></author><author><name sortKey="Bosco Bwana, Mwebesa" sort="Bosco Bwana, Mwebesa" uniqKey="Bosco Bwana M" first="Mwebesa" last="Bosco Bwana">Mwebesa Bosco Bwana</name><affiliation><nlm:aff id="dyu271-AFF1">Mbarara University of Science and Technology, Mbarara, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name><affiliation><nlm:aff id="dyu271-AFF1">City University of New York, New York, NY, USA,</nlm:aff></affiliation></author><author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D" last="Moore">Richard D. Moore</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation></author><author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Marcel Zannou, Djimon" sort="Marcel Zannou, Djimon" uniqKey="Marcel Zannou D" first="Djimon" last="Marcel Zannou">Djimon Marcel Zannou</name><affiliation><nlm:aff id="dyu271-AFF1">Centre National Hospitalier Universitaire, Cotonou, Benin,</nlm:aff></affiliation></author><author><name sortKey="Althoff, Keri N" sort="Althoff, Keri N" uniqKey="Althoff K" first="Keri N" last="Althoff">Keri N. Althoff</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation></author><author><name sortKey="Lian Lim, Poh" sort="Lian Lim, Poh" uniqKey="Lian Lim P" first="Poh" last="Lian Lim">Poh Lian Lim</name><affiliation><nlm:aff id="dyu271-AFF1">Institute of Infectious Disease, Tan Tock Seng Hospital, Singapore, Singapore,</nlm:aff></affiliation></author><author><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B" last="Nachega">Jean B. Nachega</name><affiliation><nlm:aff id="dyu271-AFF1">Department of Epidemiology, Infectious Diseases Program, Pittsburgh University, Graduate School of Public Health, Pittsburg, PA, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Department of Medicine & Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Easterbrook, Philippa J" sort="Easterbrook, Philippa J" uniqKey="Easterbrook P" first="Philippa J" last="Easterbrook">Philippa J. Easterbrook</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Kambugu, Andrew" sort="Kambugu, Andrew" uniqKey="Kambugu A" first="Andrew" last="Kambugu">Andrew Kambugu</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Little, Francesca" sort="Little, Francesca" uniqKey="Little F" first="Francesca" last="Little">Francesca Little</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Nakanjako, Damalie" sort="Nakanjako, Damalie" uniqKey="Nakanjako D" first="Damalie" last="Nakanjako">Damalie Nakanjako</name><affiliation><nlm:aff id="dyu271-AFF1">Infectious Diseases Institute, Kampala, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Kiggundu, Valerian" sort="Kiggundu, Valerian" uniqKey="Kiggundu V" first="Valerian" last="Kiggundu">Valerian Kiggundu</name><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation></author><author><name sortKey="Chung Ki Li, Patrick" sort="Chung Ki Li, Patrick" uniqKey="Chung Ki Li P" first="Patrick" last="Chung Ki Li">Patrick Chung Ki Li</name><affiliation><nlm:aff id="dyu271-AFF1">Queen Elizabeth Hospital, Hong Kong, China,</nlm:aff></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R" last="Bangsberg">David R. Bangsberg</name><affiliation><nlm:aff id="dyu271-AFF1">Center for Global Health, Massachusetts General Hospital, Harvard University, Boston, MA, USA,</nlm:aff></affiliation></author><author><name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P" last="Fox">Matthew P. Fox</name><affiliation><nlm:aff id="dyu271-AFF1">Center for Global Health and Development, Boston University, Boston, MA, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Prozesky, Hans W" sort="Prozesky, Hans W" uniqKey="Prozesky H" first="Hans W" last="Prozesky">Hans W. Prozesky</name><affiliation><nlm:aff id="dyu271-AFF1">Division of Infectious Diseases, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W" last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation><nlm:aff id="dyu271-AFF1">University of Cape Town, Cape Town, South Africa,</nlm:aff></affiliation></author><author><name sortKey="Reynolds, Steven J" sort="Reynolds, Steven J" uniqKey="Reynolds S" first="Steven J" last="Reynolds">Steven J. Reynolds</name><affiliation><nlm:aff id="dyu271-AFF1">Johns Hopkins University, Baltimore, MD, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">Rakai Health Sciences Program, Kalisizo, Uganda,</nlm:aff></affiliation><affiliation><nlm:aff id="dyu271-AFF1">National Institutes of Allergy and Infectious Diseases, Washington DC, USA,</nlm:aff></affiliation></author><author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><affiliation><nlm:aff wicri:cut=" and" id="dyu271-AFF1">University of Bern, Bern, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Yiannoutsos, Constantin T" sort="Yiannoutsos, Constantin T" uniqKey="Yiannoutsos C" first="Constantin T" last="Yiannoutsos">Constantin T. Yiannoutsos</name><affiliation><nlm:aff id="dyu271-AFF1">Indiana University, Indianapolis, IN, USA</nlm:aff></affiliation></author><author><name sortKey="Vittinghoff, Eric V" sort="Vittinghoff, Eric V" uniqKey="Vittinghoff E" first="Eric V" last="Vittinghoff">Eric V. Vittinghoff</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Deeks, Steven G" sort="Deeks, Steven G" uniqKey="Deeks S" first="Steven G" last="Deeks">Steven G. Deeks</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N" last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="dyu271-AFF1">University of California, San Francisco, CA, USA,</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Epidemiology</title><idno type="ISSN">0300-5771</idno><idno type="eISSN">1464-3685</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background:</bold> Even among HIV-infected patients who fully suppress plasma HIV RNA replication on antiretroviral therapy, genetic (e.g. CCL3L1 copy number), viral (e.g. tropism) and environmental (e.g. chronic exposure to microbial antigens) factors influence CD4 recovery. These factors differ markedly around the world and therefore the expected CD4 recovery during HIV RNA suppression may differ globally.</p><p><bold>Methods:</bold> We evaluated HIV-infected adults from North America, West Africa, East Africa, Southern Africa and Asia starting non-nucleoside reverse transcriptase inhibitor-based regimens containing efavirenz or nevirapine, who achieved at least one HIV RNA level <500/µl in the first year of therapy and observed CD4 changes during HIV RNA suppression. We used a piecewise linear regression to estimate the influence of region of residence on CD4 recovery, adjusting for socio-demographic and clinical characteristics. We observed 28 217 patients from 105 cohorts over 37 825 person-years.</p><p><bold>Results:</bold> After adjustment, patients from East Africa showed diminished CD4 recovery as compared with other regions. Three years after antiretroviral therapy initiation, the mean CD4 count for a prototypical patient with a pre-therapy CD4 count of 150/µl was 529/µl [95% confidence interval (CI): 517–541] in North America, 494/µl (95% CI: 429–559) in West Africa, 515/µl (95% CI: 508–522) in Southern Africa, 503/µl (95% CI: 478–528) in Asia and 437/µl (95% CI: 425–449) in East Africa.</p><p><bold>Conclusions:</bold> CD4 recovery during HIV RNA suppression is diminished in East Africa as compared with other regions of the world, and observed differences are large enough to potentially influence clinical outcomes. Epidemiological analyses on a global scale can identify macroscopic effects unobservable at the clinical, national or individual regional level.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Epidemiol</journal-id><journal-id journal-id-type="iso-abbrev">Int J Epidemiol</journal-id><journal-id journal-id-type="publisher-id">ije</journal-id><journal-id journal-id-type="hwp">intjepid</journal-id><journal-title-group><journal-title>International Journal of Epidemiology</journal-title></journal-title-group><issn pub-type="ppub">0300-5771</issn><issn pub-type="epub">1464-3685</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25859596</article-id><article-id pub-id-type="pmc">4339766</article-id><article-id pub-id-type="doi">10.1093/ije/dyu271</article-id><article-id pub-id-type="publisher-id">dyu271</article-id><article-categories><subj-group subj-group-type="heading"><subject>Miscellaneous</subject></subj-group></article-categories><title-group><article-title>CD4+ T cell recovery during suppression of HIV replication: an international comparison of the immunological efficacy of antiretroviral therapy in North America, Asia and Africa</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Geng</surname><given-names>Elvin H</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref><xref ref-type="corresp" rid="dyu271-COR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Neilands</surname><given-names>Torsten B</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Thièbaut</surname><given-names>Rodolphe</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bosco Bwana</surname><given-names>Mwebesa</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nash</surname><given-names>Denis</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moore</surname><given-names>Richard D</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Wood</surname><given-names>Robin</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Marcel Zannou</surname><given-names>Djimon</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Althoff</surname><given-names>Keri N</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lian Lim</surname><given-names>Poh</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nachega</surname><given-names>Jean B</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>9</sup></xref><xref ref-type="aff" rid="dyu271-AFF1"><sup>10</sup></xref><xref ref-type="aff" rid="dyu271-AFF1"><sup>11</sup></xref></contrib><contrib contrib-type="author"><name><surname>Easterbrook</surname><given-names>Philippa J</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>12</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kambugu</surname><given-names>Andrew</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>12</sup></xref></contrib><contrib contrib-type="author"><name><surname>Little</surname><given-names>Francesca</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nakigozi</surname><given-names>Gertrude</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>13</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nakanjako</surname><given-names>Damalie</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>12</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kiggundu</surname><given-names>Valerian</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>13</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chung Ki Li</surname><given-names>Patrick</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>14</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bangsberg</surname><given-names>David R</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>15</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fox</surname><given-names>Matthew P</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>16</sup></xref><xref ref-type="aff" rid="dyu271-AFF1"><sup>17</sup></xref></contrib><contrib contrib-type="author"><name><surname>Prozesky</surname><given-names>Hans W</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>18</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hunt</surname><given-names>Peter W</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Mary-Ann</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Reynolds</surname><given-names>Steven J</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>5</sup></xref><xref ref-type="aff" rid="dyu271-AFF1"><sup>13</sup></xref><xref ref-type="aff" rid="dyu271-AFF1"><sup>19</sup></xref></contrib><contrib contrib-type="author"><name><surname>Egger</surname><given-names>Matthias</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>20</sup></xref></contrib><contrib contrib-type="author"><name><surname>Yiannoutsos</surname><given-names>Constantin T</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>21</sup></xref></contrib><contrib contrib-type="author"><name><surname>Vittinghoff</surname><given-names>Eric V</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Deeks</surname><given-names>Steven G</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Martin</surname><given-names>Jeffrey N</given-names></name><xref ref-type="aff" rid="dyu271-AFF1"><sup>1</sup></xref></contrib><aff id="dyu271-AFF1"><sup>1</sup>University of California, San Francisco, CA, USA,<sup>2</sup>INSERM U897, Bordeaux University, Bordeaux, France,<sup>3</sup>Mbarara University of Science and Technology, Mbarara, Uganda,<sup>4</sup>City University of New York, New York, NY, USA,<sup>5</sup>Johns Hopkins University, Baltimore, MD, USA,<sup>6</sup>University of Cape Town, Cape Town, South Africa,<sup>7</sup>Centre National Hospitalier Universitaire, Cotonou, Benin,<sup>8</sup>Institute of Infectious Disease, Tan Tock Seng Hospital, Singapore, Singapore,<sup>9</sup>Department of Epidemiology, Infectious Diseases Program, Pittsburgh University, Graduate School of Public Health, Pittsburg, PA, USA,<sup>10</sup>Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,<sup>11</sup>Department of Medicine & Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa,<sup>12</sup>Infectious Diseases Institute, Kampala, Uganda,<sup>13</sup>Rakai Health Sciences Program, Kalisizo, Uganda,<sup>14</sup>Queen Elizabeth Hospital, Hong Kong, China,<sup>15</sup>Center for Global Health, Massachusetts General Hospital, Harvard University, Boston, MA, USA,<sup>16</sup>Center for Global Health and Development, Boston University, Boston, MA, USA,<sup>17</sup>Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,<sup>18</sup>Division of Infectious Diseases, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa,<sup>19</sup>National Institutes of Allergy and Infectious Diseases, Washington DC, USA,<sup>20</sup>University of Bern, Bern, Switzerland and<sup>21</sup>Indiana University, Indianapolis, IN, USA</aff></contrib-group><author-notes><corresp id="dyu271-COR1">*Corresponding author. Division of HIV/AIDS, San Francisco General Hospital, University of California at San Francisco, 995 Potrero Avenue, Building 80, Box 0874, San Francisco, CA 94110, USA. E-mail: <email>genge@php.ucsf.edu</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>19</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>2</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>44</volume><issue>1</issue><fpage>251</fpage><lpage>263</lpage><history><date date-type="accepted"><day>15</day><month>12</month><year>2014</year></date></history><permissions><copyright-statement>© The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association</copyright-statement><copyright-year>2015</copyright-year></permissions><abstract><p><bold>Background:</bold> Even among HIV-infected patients who fully suppress plasma HIV RNA replication on antiretroviral therapy, genetic (e.g. CCL3L1 copy number), viral (e.g. tropism) and environmental (e.g. chronic exposure to microbial antigens) factors influence CD4 recovery. These factors differ markedly around the world and therefore the expected CD4 recovery during HIV RNA suppression may differ globally.</p><p><bold>Methods:</bold> We evaluated HIV-infected adults from North America, West Africa, East Africa, Southern Africa and Asia starting non-nucleoside reverse transcriptase inhibitor-based regimens containing efavirenz or nevirapine, who achieved at least one HIV RNA level <500/µl in the first year of therapy and observed CD4 changes during HIV RNA suppression. We used a piecewise linear regression to estimate the influence of region of residence on CD4 recovery, adjusting for socio-demographic and clinical characteristics. We observed 28 217 patients from 105 cohorts over 37 825 person-years.</p><p><bold>Results:</bold> After adjustment, patients from East Africa showed diminished CD4 recovery as compared with other regions. Three years after antiretroviral therapy initiation, the mean CD4 count for a prototypical patient with a pre-therapy CD4 count of 150/µl was 529/µl [95% confidence interval (CI): 517–541] in North America, 494/µl (95% CI: 429–559) in West Africa, 515/µl (95% CI: 508–522) in Southern Africa, 503/µl (95% CI: 478–528) in Asia and 437/µl (95% CI: 425–449) in East Africa.</p><p><bold>Conclusions:</bold> CD4 recovery during HIV RNA suppression is diminished in East Africa as compared with other regions of the world, and observed differences are large enough to potentially influence clinical outcomes. Epidemiological analyses on a global scale can identify macroscopic effects unobservable at the clinical, national or individual regional level.</p></abstract><kwd-group><kwd>HIV</kwd><kwd>Africa</kwd><kwd>antiretroviral therapy</kwd><kwd>CD4 + T cell counts</kwd><kwd>immunological activation</kwd></kwd-group><counts><page-count count="13"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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