Pujari S, Patel A, Naik E, Dravid A, Patel K; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. B11380.
CHART and Ruby Hall Clinic, Pune, India
Aim: To assess immunological improvement amongst antiretroviral naive HIV infected patients stratified according to baseline CD4 counts on NVP-based HAARTDesign: prospective cohort studySetting: Two tertiary level HIV clinics in IndiaMethod: Antiretroviral naive patients initiating NVP based HAART were recruited consecutively and followed up clinically and with CD4 counts quarterly. CD4 counts were estimated by FACS count. After the lead-in dose patients were initiated on fixed dose combination of d4T/3TC/NVP or AZT/3TC/NVP. Adherence was assessed by self-report. CD4 counts were estimated by FACS count. The difference in mean CD4 improvement in patients starting ART at CD4<50, 51-200, >200 was assessed by Kruskal-Wallis test (with Dunns multiple comparisons test) at 3,6 and 12 months. Kaplan Meir curves were plotted for time to CD4>350 for each of the baseline CD4 strata and differences assessed by log rank test. Results: A total of 1253 patients with minimum of 3 months of follow up were included in the final analysis. Maximal increase in CD4 counts occured within 3-6 months of starting HAART, after which there is only a gradual increase. Following table depicts the mean change in CD4 counts at various time points: [table: see text] However, time to achieve CD4>350 was significantly longer in patients starting at CD4<50 and 51-200 as compared to CD4>200. Conclusion: Though time to normalization (CD4>350) is much longer when started late; absolute increase in CD4 counts is higher in patients starting HAART at CD4<200. Antiretroviral therapy is effective in improving quantitative immune response even when started at advanced stage of HIV infection.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Antigens, CD4
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- HIV
- HIV Infections
- HIV Protease Inhibitors
- Humans
- Lamivudine
- Longitudinal Studies
- Stavudine
- Zidovudine
- immunology
Other ID:
UI: 102276674
From Meeting Abstracts