Factors associated with poor immunologic response to virologic suppression by highly active antiretroviral therapy in HIV-infected women

Carlos M. Vaamonde, Donald R. Hoover, Kathryn Anastos, Tianren Tan, Qiuhu Shi, Wei Gao, Andrea Kovacs, Mardge Cohen, Jack Dehovitz, Marshall J. Glesby

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Abstract

Virologic response to highly active antiretroviral therapy (HAART) typically results in a substantial rise in CD4 cell counts. We investigated factors associated with poor CD4 response among HIV-infected women followed at 6-monthly intervals in the Women's Interagency HIV Study. Women with nadir CD4 counts <350 cells/mm3 who achieved at least 6 months of plasma HIV RNA < 400 copies/ml were studied. Demographic, clinical, and treatment factors were compared between immunologic nonresponders, defined as the lower quartile of CD4 count change after two visits with virologic suppression (<56 cell/mm3; n = 38), and the remaining group of responders (n = 115). Immunologic nonresponders had lower baseline HIV RNA levels and higher CD4 counts, more frequently used HAART 6 months prior to achieving consistent viral suppression, and more commonly had HIV RNA levels >80 but <400 copies/mL at both suppressive visits (21 vs. 7.8%, p = 0.024). In multivariate analysis, higher CD4 count and lower HIV RNA level at the last presuppressive visit were associated with immune nonresponse. We conclude that higher baseline CD4 count and lower HIV RNA level were associated with poor immunologic response to HAART in women with virologic suppression for at least 6 months. Persistent low level viremia may also contribute.

Original languageEnglish (US)
Pages (from-to)222-231
Number of pages10
JournalAIDS Research and Human Retroviruses
Volume22
Issue number3
DOIs
StatePublished - Mar 2006

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Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
HIV
RNA
Viremia
Multivariate Analysis

ASJC Scopus subject areas

  • Immunology
  • Virology

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Factors associated with poor immunologic response to virologic suppression by highly active antiretroviral therapy in HIV-infected women. / Vaamonde, Carlos M.; Hoover, Donald R.; Anastos, Kathryn; Tan, Tianren; Shi, Qiuhu; Gao, Wei; Kovacs, Andrea; Cohen, Mardge; Dehovitz, Jack; Glesby, Marshall J.

In: AIDS Research and Human Retroviruses, Vol. 22, No. 3, 03.2006, p. 222-231.

Research output: Contribution to journalArticle

Vaamonde, Carlos M. ; Hoover, Donald R. ; Anastos, Kathryn ; Tan, Tianren ; Shi, Qiuhu ; Gao, Wei ; Kovacs, Andrea ; Cohen, Mardge ; Dehovitz, Jack ; Glesby, Marshall J. / Factors associated with poor immunologic response to virologic suppression by highly active antiretroviral therapy in HIV-infected women. In: AIDS Research and Human Retroviruses. 2006 ; Vol. 22, No. 3. pp. 222-231.
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