Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.
Identifieur interne : 000147 ( Hal/Corpus ); précédent : 000146; suivant : 000148Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.
Auteurs : Alexandra Calmy ; Eric Balestre ; Fabrice Bonnet ; Andrew Boulle ; Eduardo Sprinz ; Robin Wood ; Eric Delaporte ; Eugène Messou ; James Mcintyre ; Kamal El Filali ; Mauro Schechter ; N. Kumarasamy ; David Bangsberg ; Patrick Mcphail ; Stefaan Van Der Borght ; Carlos Zala ; Matthias Egger ; Rodolphe Thiébaut ; François DabisSource :
- BMC Infectious Diseases [ 1471-2334 ] ; 2012-06-28.
English descriptors
Abstract
ABSTRACT: BACKGROUND: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART. METHOD: Naive patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART. RESULTS: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/uL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12. CONCLUSION: In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.
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2</orgName><desc><address><addrLine>146 rue Léo Saignat - 33076 Bordeaux cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-bordeauxsegalen.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">HAL</idno><idno type="RBID">Hal:inserm-00788673</idno><idno type="halId">inserm-00788673</idno><idno type="halUri">http://www.hal.inserm.fr/inserm-00788673</idno><idno type="url">http://www.hal.inserm.fr/inserm-00788673</idno><date when="2012-06-28">2012-06-28</date><idno type="wicri:Area/Hal/Corpus">000147</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.</title><author><name sortKey="Calmy, Alexandra" sort="Calmy, Alexandra" uniqKey="Calmy A" first="Alexandra" last="Calmy">Alexandra Calmy</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214696" status="INCOMING"><orgName>HIV Unit</orgName><desc><address><addrLine>4 rue Gabrielle Perret Gentil, Geneva</addrLine><country key="CH"></country></address></desc><listRelation><relation active="#struct-310582" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-310582" type="direct"><org type="institution" xml:id="struct-310582" status="INCOMING"><orgName>Geneva University Hospital</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Balestre, Eric" sort="Balestre, Eric" uniqKey="Balestre E" first="Eric" last="Balestre">Eric Balestre</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-55677" status="VALID"><orgName>Epidémiologie et Biostatistique [Bordeaux]</orgName><desc><address><addrLine>146, rue Léo-Saignat 33076 Bordeaux</addrLine><country key="FR"></country></address></desc><listRelation><relation name="U897" active="#struct-303623" type="direct"></relation><relation active="#struct-302259" type="direct"></relation><relation active="#struct-91134" type="direct"></relation></listRelation><tutelles><tutelle name="U897" active="#struct-303623" type="direct"><org type="institution" xml:id="struct-303623" status="VALID"><idno type="IdRef">026388278</idno><orgName>Institut National de la Santé et de la Recherche Médicale</orgName><orgName type="acronym">INSERM</orgName><desc><address><addrLine>101, rue de Tolbiac, 75013 Paris </addrLine><country key="FR"></country></address><ref type="url">http://www.inserm.fr</ref></desc></org></tutelle><tutelle active="#struct-302259" type="direct"><org type="institution" xml:id="struct-302259" status="VALID"><orgName>Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-91134" type="direct"><org type="institution" xml:id="struct-91134" status="OLD"><orgName>Université Bordeaux Segalen - Bordeaux 2</orgName><desc><address><addrLine>146 rue Léo Saignat - 33076 Bordeaux cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-bordeauxsegalen.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Bonnet, Fabrice" sort="Bonnet, Fabrice" uniqKey="Bonnet F" first="Fabrice" last="Bonnet">Fabrice Bonnet</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214700" status="INCOMING"><orgName>Service de Médecine Interne et Maladies Infectieuses</orgName><desc><address><addrLine>Bordeaux</addrLine><country key="FR"></country></address></desc><listRelation><relation active="#struct-300122" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300122" type="direct"><org type="institution" xml:id="struct-300122" status="VALID"><orgName>CHU Bordeaux [Bordeaux]</orgName><desc><address><addrLine>place Amélie Raba Léon33076 BORDEAUX CEDEX</addrLine><country key="FR"></country></address><ref type="url">http://www.chu-bordeaux.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Boulle, Andrew" sort="Boulle, Andrew" uniqKey="Boulle A" first="Andrew" last="Boulle">Andrew Boulle</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214701" status="INCOMING"><orgName>School of Public Health and Family Medicine</orgName><desc><address><addrLine>Cape Town</addrLine><country key="ZA"></country></address></desc><listRelation><relation active="#struct-303907" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-303907" type="direct"><org type="institution" xml:id="struct-303907" status="VALID"><orgName>University of Cape Town</orgName><desc><address><country key="ZA"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Sprinz, Eduardo" sort="Sprinz, Eduardo" uniqKey="Sprinz E" first="Eduardo" last="Sprinz">Eduardo Sprinz</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214702" status="INCOMING"><orgName>South Brazil HIV Cohort</orgName><desc><address><addrLine>Porto Alegre</addrLine><country key="BR"></country></address></desc><listRelation><relation active="#struct-333812" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-333812" type="direct"><org type="institution" xml:id="struct-333812" status="INCOMING"><orgName>Hospital de Clínicas de Porto Alegre</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214703" status="INCOMING"><orgName>Gugulethu ART Programme</orgName><desc><address><addrLine>Gugulethu</addrLine><country key="ZA"></country></address></desc><listRelation><relation active="#struct-352300" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352300" type="direct"><org type="institution" xml:id="struct-352300" status="INCOMING"><orgName>Gugulethu ART Programme</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Delaporte, Eric" sort="Delaporte, Eric" uniqKey="Delaporte E" first="Eric" last="Delaporte">Eric Delaporte</name><affiliation><hal:affiliation type="institution" xml:id="struct-67872" status="VALID"><orgName>Institut de Recherche pour le Développement</orgName><orgName type="acronym">IRD</orgName><desc><address><addrLine>SiègeLe Sextant 44, bd de DunkerqueCS 9000913572 Marseille cedex 02</addrLine><country key="FR"></country></address><ref type="url">http://www.ird.fr/</ref></desc></hal:affiliation></affiliation></author><author><name sortKey="Messou, Eugene" sort="Messou, Eugene" uniqKey="Messou E" first="Eugène" last="Messou">Eugène Messou</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214705" status="INCOMING"><orgName>Centre de Prise en Charge, de Recherche et de Formation sur le VIH/SIDA</orgName><desc><address><addrLine>Abidjan</addrLine><country key="CI"></country></address></desc><listRelation><relation active="#struct-352313" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352313" type="direct"><org type="institution" xml:id="struct-352313" status="INCOMING"><orgName>CePReF</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Mcintyre, James" sort="Mcintyre, James" uniqKey="Mcintyre J" first="James" last="Mcintyre">James Mcintyre</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214706" status="INCOMING"><orgName>Perinatal HIV Research Unit</orgName><desc><address><addrLine>Soweto</addrLine><country key="ZA"></country></address></desc><listRelation><relation active="#struct-352301" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352301" type="direct"><org type="institution" xml:id="struct-352301" status="INCOMING"><orgName>Operational Research on ART (OPERA)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="El Filali, Kamal" sort="El Filali, Kamal" uniqKey="El Filali K" first="Kamal" last="El Filali">Kamal El Filali</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214707" status="INCOMING"><orgName>Service des Maladies Infectieuses</orgName><desc><address><addrLine>Casablanca</addrLine><country key="MA"></country></address></desc><listRelation><relation active="#struct-352302" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352302" type="direct"><org type="institution" xml:id="struct-352302" status="INCOMING"><orgName>Hôpital Ibn Rochd</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Schechter, Mauro" sort="Schechter, Mauro" uniqKey="Schechter M" first="Mauro" last="Schechter">Mauro Schechter</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214708" status="INCOMING"><orgName>Rio HIV Cohort</orgName><desc><address><addrLine>Rio de Janeiro</addrLine><country key="BR"></country></address></desc><listRelation><relation active="#struct-352303" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352303" type="direct"><org type="institution" xml:id="struct-352303" status="INCOMING"><orgName>Rio HIV Cohort</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Kumarasamy, N" sort="Kumarasamy, N" uniqKey="Kumarasamy N" first="N" last="Kumarasamy">N. Kumarasamy</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214709" status="INCOMING"><orgName>YRG Centre for AIDS Research and Education</orgName><desc><address><addrLine>Chennai</addrLine><country key="IN"></country></address></desc><listRelation><relation active="#struct-352304" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352304" type="direct"><org type="institution" xml:id="struct-352304" status="INCOMING"><orgName>YRG Centre for AIDS Research and Education</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Bangsberg, David" sort="Bangsberg, David" uniqKey="Bangsberg D" first="David" last="Bangsberg">David Bangsberg</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214710" status="INCOMING"><orgName>Immune Suppression Syndrome Clinic (ISS)</orgName><desc><address><addrLine>Mbarara</addrLine><country key="UG"></country></address></desc><listRelation><relation active="#struct-352305" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352305" type="direct"><org type="institution" xml:id="struct-352305" status="INCOMING"><orgName>Immune Suppression Syndrome Clinic (ISS)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Mcphail, Patrick" sort="Mcphail, Patrick" uniqKey="Mcphail P" first="Patrick" last="Mcphail">Patrick Mcphail</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214711" status="INCOMING"><orgName>Helen Joseph Hospital Themba Lethu Clinic</orgName><desc><address><addrLine>Johannesburg</addrLine><country key="ZA"></country></address></desc><listRelation><relation active="#struct-352306" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352306" type="direct"><org type="institution" xml:id="struct-352306" status="INCOMING"><orgName>Helen Joseph Hospital Themba Lethu Clinic</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Van Der Borght, Stefaan" sort="Van Der Borght, Stefaan" uniqKey="Van Der Borght S" first="Stefaan" last="Van Der Borght">Stefaan Van Der Borght</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-44269" status="INCOMING"><orgName>Heineken International Health Affairs</orgName><desc><address><addrLine>Amsterdam</addrLine><country key="NL"></country></address></desc><listRelation><relation active="#struct-310676" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-310676" type="direct"><org type="institution" xml:id="struct-310676" status="INCOMING"><orgName>Heineken International Health Affairs</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Zala, Carlos" sort="Zala, Carlos" uniqKey="Zala C" first="Carlos" last="Zala">Carlos Zala</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-214713" status="INCOMING"><orgName>Prospective Evaluation in the Use and Monitoring of Antiretrovirals in Argentina</orgName><desc><address><addrLine>Buenos Aires</addrLine><country key="AR"></country></address></desc><listRelation><relation active="#struct-352314" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-352314" type="direct"><org type="institution" xml:id="struct-352314" status="INCOMING"><orgName>PUMA</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-95839" status="INCOMING"><orgName>Institute of Social and Preventive Medicine</orgName><orgName type="acronym">ISPM</orgName><desc><address><country key="CH"></country></address></desc><listRelation><relation active="#struct-300574" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300574" type="direct"><org type="institution" xml:id="struct-300574" status="INCOMING"><orgName>University of Bern</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thiébaut">Rodolphe Thiébaut</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-55677" status="VALID"><orgName>Epidémiologie et Biostatistique [Bordeaux]</orgName><desc><address><addrLine>146, rue Léo-Saignat 33076 Bordeaux</addrLine><country key="FR"></country></address></desc><listRelation><relation name="U897" active="#struct-303623" type="direct"></relation><relation active="#struct-302259" type="direct"></relation><relation active="#struct-91134" type="direct"></relation></listRelation><tutelles><tutelle name="U897" active="#struct-303623" type="direct"><org type="institution" xml:id="struct-303623" status="VALID"><idno type="IdRef">026388278</idno><orgName>Institut National de la Santé et de la Recherche Médicale</orgName><orgName type="acronym">INSERM</orgName><desc><address><addrLine>101, rue de Tolbiac, 75013 Paris </addrLine><country key="FR"></country></address><ref type="url">http://www.inserm.fr</ref></desc></org></tutelle><tutelle active="#struct-302259" type="direct"><org type="institution" xml:id="struct-302259" status="VALID"><orgName>Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-91134" type="direct"><org type="institution" xml:id="struct-91134" status="OLD"><orgName>Université Bordeaux Segalen - Bordeaux 2</orgName><desc><address><addrLine>146 rue Léo Saignat - 33076 Bordeaux cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-bordeauxsegalen.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author><author><name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="François" last="Dabis">François Dabis</name><affiliation><hal:affiliation type="laboratory" xml:id="struct-55677" status="VALID"><orgName>Epidémiologie et Biostatistique [Bordeaux]</orgName><desc><address><addrLine>146, rue Léo-Saignat 33076 Bordeaux</addrLine><country key="FR"></country></address></desc><listRelation><relation name="U897" active="#struct-303623" type="direct"></relation><relation active="#struct-302259" type="direct"></relation><relation active="#struct-91134" type="direct"></relation></listRelation><tutelles><tutelle name="U897" active="#struct-303623" type="direct"><org type="institution" xml:id="struct-303623" status="VALID"><idno type="IdRef">026388278</idno><orgName>Institut National de la Santé et de la Recherche Médicale</orgName><orgName type="acronym">INSERM</orgName><desc><address><addrLine>101, rue de Tolbiac, 75013 Paris </addrLine><country key="FR"></country></address><ref type="url">http://www.inserm.fr</ref></desc></org></tutelle><tutelle active="#struct-302259" type="direct"><org type="institution" xml:id="struct-302259" status="VALID"><orgName>Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-91134" type="direct"><org type="institution" xml:id="struct-91134" status="OLD"><orgName>Université Bordeaux Segalen - Bordeaux 2</orgName><desc><address><addrLine>146 rue Léo Saignat - 33076 Bordeaux cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-bordeauxsegalen.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="ISSN">1471-2334</idno><imprint><date type="datePub">2012-06-28</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term>CD4 count</term><term>CD4 slope</term><term>HIV-1</term><term>HIV-RNA threshold</term><term>Resource limited settings</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">ABSTRACT: BACKGROUND: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART. METHOD: Naive patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART. RESULTS: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/uL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12. CONCLUSION: In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.</div></front></TEI><hal api="V3"><titleStmt><title xml:lang="en">Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.</title><author role="crp"><persName><forename type="first">Alexandra</forename><surname>Calmy</surname></persName><email>acalmy@gmail.com</email><idno type="halauthor">817468</idno><affiliation ref="#struct-214696"></affiliation></author><author role="aut"><persName><forename type="first">Eric</forename><surname>Balestre</surname></persName><email>eric.balestre@isped.u-bordeaux2.fr</email><idno type="halauthor">817469</idno><affiliation ref="#struct-55677"></affiliation></author><author role="aut"><persName><forename type="first">Fabrice</forename><surname>Bonnet</surname></persName><email>Fabrice.Bonnet@chu-bordeaux.fr</email><idno type="halauthor">366391</idno><affiliation ref="#struct-214700"></affiliation></author><author role="aut"><persName><forename type="first">Andrew</forename><surname>Boulle</surname></persName><email>andrew.boulle@uct.ac.za</email><idno type="halauthor">817470</idno><affiliation ref="#struct-214701"></affiliation></author><author role="aut"><persName><forename type="first">Eduardo</forename><surname>Sprinz</surname></persName><email>esprinz@hcpa.ufrgs.br</email><idno type="halauthor">817471</idno><affiliation ref="#struct-214702"></affiliation></author><author role="aut"><persName><forename type="first">Robin</forename><surname>Wood</surname></persName><email>robin.wood@hiv-research.org.za</email><idno type="halauthor">817472</idno><affiliation ref="#struct-214703"></affiliation></author><author role="aut"><persName><forename type="first">Eric</forename><surname>Delaporte</surname></persName><email>e-delaporte@chu-montpellier.fr</email><idno type="halauthor">817473</idno><affiliation ref="#struct-67872"></affiliation></author><author role="aut"><persName><forename type="first">Eugène</forename><surname>Messou</surname></persName><email>messou_eugene@yahoo.fr</email><idno type="halauthor">817474</idno><affiliation ref="#struct-214705"></affiliation></author><author role="aut"><persName><forename type="first">James</forename><surname>McIntyre</surname></persName><email>James.McIntyre@obgyn.net</email><idno type="halauthor">817475</idno><affiliation ref="#struct-214706"></affiliation></author><author role="aut"><persName><forename type="first">Kamal</forename><forename type="middle">Marhoum</forename><surname>El Filali</surname></persName><email>mefkamal@hotmail.com</email><idno type="halauthor">817476</idno><affiliation ref="#struct-214707"></affiliation></author><author role="aut"><persName><forename type="first">Mauro</forename><surname>Schechter</surname></persName><email>maurosch@hucff.ufrj.br</email><idno type="halauthor">817477</idno><affiliation ref="#struct-214708"></affiliation></author><author role="aut"><persName><forename type="first">N</forename><surname>Kumarasamy</surname></persName><email>kumarasamy@yrgcare.org</email><idno type="halauthor">817478</idno><affiliation ref="#struct-214709"></affiliation></author><author role="aut"><persName><forename type="first">David</forename><surname>Bangsberg</surname></persName><email>dbangsberg@partners.org</email><idno type="halauthor">817479</idno><affiliation ref="#struct-214710"></affiliation></author><author role="aut"><persName><forename type="first">Patrick</forename><surname>McPhail</surname></persName><email>macphailap@medicine.wits.ac.za</email><idno type="halauthor">817480</idno><affiliation ref="#struct-214711"></affiliation></author><author role="aut"><persName><forename type="first">Stefaan</forename><surname>Van Der Borght</surname></persName><email>Stefaan.vanderBorght@heineken.com</email><idno type="halauthor">817481</idno><affiliation ref="#struct-44269"></affiliation></author><author role="aut"><persName><forename type="first">Carlos</forename><surname>Zala</surname></persName><email>czala@teletel.com.ar</email><idno type="halauthor">817482</idno><affiliation ref="#struct-214713"></affiliation></author><author role="aut"><persName><forename type="first">Matthias</forename><surname>Egger</surname></persName><email>egger@ispm.unibe.ch</email><idno type="halauthor">400841</idno><affiliation ref="#struct-95839"></affiliation></author><author role="aut"><persName><forename type="first">Rodolphe</forename><surname>Thiébaut</surname></persName><email>rodolphe.thiebaut@isped.u-bordeaux2.fr</email><idno type="halauthor">183458</idno><affiliation ref="#struct-55677"></affiliation></author><author role="aut"><persName><forename type="first">François</forename><surname>Dabis</surname></persName><email>Francois.Dabis@isped.u-bordeaux2.fr</email><idno type="halauthor">206160</idno><affiliation ref="#struct-55677"></affiliation></author><editor role="depositor"><persName><forename>Ed.</forename><surname>BMC</surname></persName><email>marianne.haska@biomedcentral.com</email></editor><funder>The ART-LINC of IeDEA Collaboration was funded by the United States National Institute of Health (NIH - Office of AIDS Research) together with the French Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS - grants 12101 and 12138). The IeDEA network is now funded through collaborative agreements by the National Cancer Institute (NCI), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Allergy And Infectious Diseases (NIAID).</funder></titleStmt><editionStmt><edition n="v1" type="current"><date type="whenSubmitted">2013-02-14 21:09:57</date><date type="whenModified">2015-02-26 11:03:06</date><date type="whenReleased">2013-02-15 10:30:51</date><date type="whenProduced">2012-06-28</date><date type="whenEndEmbargoed">2013-02-14</date><ref type="file" target="http://www.hal.inserm.fr/inserm-00788673/document"><date notBefore="2013-02-14"></date></ref><ref type="file" subtype="greenPublisher" n="1" target="http://www.hal.inserm.fr/inserm-00788673/file/1471-2334-12-147.pdf"><date notBefore="2013-02-14"></date></ref><ref type="annex" subtype="other" n="0" target="http://www.hal.inserm.fr/inserm-00788673/file/1471-2334-12-147.xml"><date notBefore="2013-02-14"></date></ref></edition><respStmt><resp>contributor</resp><name key="151596"><persName><forename>Ed.</forename><surname>BMC</surname></persName><email>marianne.haska@biomedcentral.com</email></name></respStmt></editionStmt><publicationStmt><distributor>CCSD</distributor><idno type="halId">inserm-00788673</idno><idno type="halUri">http://www.hal.inserm.fr/inserm-00788673</idno><idno type="halBibtex">calmy:inserm-00788673</idno><idno type="halRefHtml">BMC Infectious Diseases, BioMed Central, 2012, 12 (1), pp.147. <10.1186/1471-2334-12-147></idno><idno type="halRef">BMC Infectious Diseases, BioMed Central, 2012, 12 (1), pp.147. <10.1186/1471-2334-12-147></idno></publicationStmt><seriesStmt><idno type="stamp" n="INSERM">INSERM - Institut national de la santé et de la recherche médicale</idno><idno type="stamp" n="UNIV-BORDEAUX2">Université Victor Segalen - Bordeaux II</idno><idno type="stamp" n="UNIV-BORDEAUX">Université de Bordeaux</idno><idno type="stamp" n="IRD">IRD - Institut de recherche pour le développement</idno></seriesStmt><notesStmt><note type="audience" n="2">International</note><note type="popular" n="0">No</note><note type="peer" n="1">Yes</note></notesStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.</title><author role="crp"><persName><forename type="first">Alexandra</forename><surname>Calmy</surname></persName><email>acalmy@gmail.com</email><idno type="halAuthorId">817468</idno><affiliation ref="#struct-214696"></affiliation></author><author role="aut"><persName><forename type="first">Eric</forename><surname>Balestre</surname></persName><email>eric.balestre@isped.u-bordeaux2.fr</email><idno type="halAuthorId">817469</idno><affiliation ref="#struct-55677"></affiliation></author><author role="aut"><persName><forename type="first">Fabrice</forename><surname>Bonnet</surname></persName><email>Fabrice.Bonnet@chu-bordeaux.fr</email><idno type="halAuthorId">366391</idno><affiliation ref="#struct-214700"></affiliation></author><author role="aut"><persName><forename type="first">Andrew</forename><surname>Boulle</surname></persName><email>andrew.boulle@uct.ac.za</email><idno type="halAuthorId">817470</idno><affiliation ref="#struct-214701"></affiliation></author><author role="aut"><persName><forename type="first">Eduardo</forename><surname>Sprinz</surname></persName><email>esprinz@hcpa.ufrgs.br</email><idno type="halAuthorId">817471</idno><affiliation ref="#struct-214702"></affiliation></author><author role="aut"><persName><forename type="first">Robin</forename><surname>Wood</surname></persName><email>robin.wood@hiv-research.org.za</email><idno type="halAuthorId">817472</idno><affiliation ref="#struct-214703"></affiliation></author><author role="aut"><persName><forename type="first">Eric</forename><surname>Delaporte</surname></persName><email>e-delaporte@chu-montpellier.fr</email><idno type="halAuthorId">817473</idno><affiliation ref="#struct-67872"></affiliation></author><author role="aut"><persName><forename type="first">Eugène</forename><surname>Messou</surname></persName><email>messou_eugene@yahoo.fr</email><idno type="halAuthorId">817474</idno><affiliation ref="#struct-214705"></affiliation></author><author role="aut"><persName><forename type="first">James</forename><surname>McIntyre</surname></persName><email>James.McIntyre@obgyn.net</email><idno type="halAuthorId">817475</idno><affiliation ref="#struct-214706"></affiliation></author><author role="aut"><persName><forename type="first">Kamal</forename><forename type="middle">Marhoum</forename><surname>El Filali</surname></persName><email>mefkamal@hotmail.com</email><idno type="halAuthorId">817476</idno><affiliation ref="#struct-214707"></affiliation></author><author role="aut"><persName><forename type="first">Mauro</forename><surname>Schechter</surname></persName><email>maurosch@hucff.ufrj.br</email><idno type="halAuthorId">817477</idno><affiliation ref="#struct-214708"></affiliation></author><author role="aut"><persName><forename type="first">N</forename><surname>Kumarasamy</surname></persName><email>kumarasamy@yrgcare.org</email><idno type="halAuthorId">817478</idno><affiliation ref="#struct-214709"></affiliation></author><author role="aut"><persName><forename type="first">David</forename><surname>Bangsberg</surname></persName><email>dbangsberg@partners.org</email><idno type="halAuthorId">817479</idno><affiliation ref="#struct-214710"></affiliation></author><author role="aut"><persName><forename type="first">Patrick</forename><surname>McPhail</surname></persName><email>macphailap@medicine.wits.ac.za</email><idno type="halAuthorId">817480</idno><affiliation ref="#struct-214711"></affiliation></author><author role="aut"><persName><forename type="first">Stefaan</forename><surname>Van Der Borght</surname></persName><email>Stefaan.vanderBorght@heineken.com</email><idno type="halAuthorId">817481</idno><affiliation ref="#struct-44269"></affiliation></author><author role="aut"><persName><forename type="first">Carlos</forename><surname>Zala</surname></persName><email>czala@teletel.com.ar</email><idno type="halAuthorId">817482</idno><affiliation ref="#struct-214713"></affiliation></author><author role="aut"><persName><forename type="first">Matthias</forename><surname>Egger</surname></persName><email>egger@ispm.unibe.ch</email><idno type="halAuthorId">400841</idno><affiliation ref="#struct-95839"></affiliation></author><author role="aut"><persName><forename type="first">Rodolphe</forename><surname>Thiébaut</surname></persName><email>rodolphe.thiebaut@isped.u-bordeaux2.fr</email><idno type="halAuthorId">183458</idno><affiliation ref="#struct-55677"></affiliation></author><author role="aut"><persName><forename type="first">François</forename><surname>Dabis</surname></persName><email>Francois.Dabis@isped.u-bordeaux2.fr</email><idno type="halAuthorId">206160</idno><affiliation ref="#struct-55677"></affiliation></author></analytic><monogr><idno type="halJournalId" status="VALID">337</idno><idno type="issn">1471-2334</idno><title level="j">BMC Infectious Diseases</title><imprint><publisher>BioMed Central</publisher><biblScope unit="volume">12</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="pp">147</biblScope><date type="datePub">2012-06-28</date><date type="dateEpub">2012-06-28</date></imprint></monogr><idno type="doi">10.1186/1471-2334-12-147</idno><idno type="pubmed">22742573</idno></biblStruct></sourceDesc><profileDesc><langUsage><language ident="en">English</language></langUsage><textClass><keywords scheme="author"><term xml:lang="en">HIV-1</term><term xml:lang="en">CD4 count</term><term xml:lang="en">CD4 slope</term><term xml:lang="en">HIV-RNA threshold</term><term xml:lang="en">Resource limited settings</term></keywords><classCode scheme="halDomain" n="sdv.mhep.mi">Life Sciences [q-bio]/Human health and pathology/Infectious diseases</classCode><classCode scheme="halTypology" n="ART">Journal articles</classCode></textClass><abstract xml:lang="en">ABSTRACT: BACKGROUND: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART. METHOD: Naive patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART. RESULTS: 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/uL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12. CONCLUSION: In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.</abstract><particDesc><org type="consortium">for the ART-LINC of IeDEA Collaboration (Asia</org><org type="consortium">South America</org><org type="consortium">East</org><org type="consortium">Southern and West Africa)</org></particDesc></profileDesc></hal></record>Pour manipuler ce document sous Unix (Dilib)
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