The Incidence of AIDS-Defining Illnesses at a Current CD4 Count ≥200 Cells/µL in the Post–Combination Antiretroviral Therapy Era

Amanda Mocroft; H J Furrer; J M Miro; P. Reiss; C. Mussini; O. Kirk; Sophie Abgrall; S. Ayayi; B. Bartmeyer; D. Braun; A. Castagna; A. d'Arminio Monforte; B. Gazzard; F. Gutierrez; I. Hurtado; K. Jansen; L. Meyer; P. Muñoz; N. Obel; P. Soler-Palacin; A. Papadopoulos; F. Raffi; J T Ramos; J K Rockstroh; D. Salmon; C. Torti; J. Warszawski; S. de Wit; R. Zangerle; C. Fabre-Colin; J. Kjaer; G. Chene; J. Grarup; J D Lundgren; Hansjakob Furrer; Jose Miro; Peter Reiss; Cristina Mussini; Ole Kirk; Sylvie Ayayi; Barbara Bartmeyer; Dominique Braun; Antonella Castagna; Antonella d'Arminio Monforte; Brian Gazzard; Félix Gutierrez; Isabel Hurtado; Klaus Jansen; Laurence Meyer; Pepa Muñoz; Niels Obel; Pere Soler-Palacin; Antonios Papadopoulos; François Raffi; Jose Ramos; Jürgen Rockstroh; Dominique Salmon; Carlo Torti; Josianne Warszawski; Stephane de Wit; Robert Zangerle; Céline Fabre-Colin; Jesper Kjaer; Genevieve Chene; Jesper Grarup; Jens Lundgren; Jose Miiro; Pere Soler Palacin; Carolo Torti; Josiane Warszawski; Jurgen Rockstroh; José Ramos; Jose Miró; Pepa Munoz; Ali Judd; David Haerry; Ian Weller; Jordi Casabona; Dominique Costagliola; Antonella d'Arminio-Monforte; Manuel Battegay; Maria Prins; Frank de Wolf; Céline Colin; Christine Schwimmer; Guillaume Touzeau; Maria Campbell; Julia Bohlius; Vincent Bouteloup; Heiner Bucher; Alessandro Cozzi-Lepri; François Dabis; Maria Dorrucci; Matthias Egger; Frederik Engsig; Olivier Lambotte; Charlotte Lewden; Rebecca Lodwick; Sophie Matheron; Roger Paredes; Andrew Phillips; Massimo Puoti; Joanne Reekie; Caroline Sabin; Alexandra Scherrer; Colette Smit; Jonathan Sterne; Rodolphe Thiebaut; Claire Thorne; Viktor von Wyl; Linda Wittkop; Jim Young

doi:10.1093/cid/cit423

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The Incidence of AIDS-Defining Illnesses at a Current CD4 Count ≥200 Cells/µL in the Post–Combination Antiretroviral Therapy Era

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The Incidence of AIDS-Defining Illnesses at a Current CD4 Count ≥200 Cells/µL in the Post–Combination Antiretroviral Therapy Era

Amanda Mocroft, H J Furrer, J M Miro, P. Reiss, C. Mussini, O. Kirk, Sophie Abgrall, S. Ayayi, B. Bartmeyer, D. Braun, …

Clinical Infectious Diseases, Vol.57(7), pp.1038-1047

01/10/2013

DOI: https://doi.org/10.1093/cid/cit423

Abstract

Background. Few studies consider the incidence of individual AIDS-defining illnesses (ADIs) at higher CD4 counts, relevant on a population level for monitoring and resource allocation.Methods. Individuals from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) aged ≥14 years with ≥1 CD4 count of ≥200 µL between 1998 and 2010 were included. Incidence rates (per 1000 personyears of follow-up [PYFU]) were calculated for each ADI within different CD4 strata; Poisson regression, using generalized estimating equations and robust standard errors, was used to model rates of ADIs with current CD4 ≥500/µL.Results. A total of 12 135 ADIs occurred at a CD4 count of ≥200 cells/µL among 207 539 persons with 1 154 803 PYFU. Incidence rates declined from 20.5 per 1000 PYFU (95% confidence interval [CI], 20.0–21.1 per 1000 PYFU) with current CD4 200–349 cells/µL to 4.1 per 1000 PYFU (95% CI, 3.6–4.6 per 1000 PYFU) with current CD4 ≥ 1000 cells/µL. Persons with a current CD4 of 500–749 cells/µL had a significantly higher rate of ADIs (adjusted incidence rate ratio [aIRR], 1.20; 95% CI, 1.10–1.32), whereas those with a current CD4 of ≥1000 cells/µL had a similar rate (aIRR, 0.92; 95% CI, .79–1.07), compared to a current CD4 of 750–999 cells/µL. Results were consistent in persons with high or low viral load. Findings were stronger for malignant ADIs (aIRR, 1.52; 95% CI, 1.25–1.86) than for nonmalignant ADIs (aIRR, 1.12; 95% CI, 1.01–1.25), comparing persons with a current CD4 of 500–749 cells/µL to 750–999 cells/µL.Discussion. The incidence of ADIs was higher in individuals with a current CD4 count of 500–749 cells/µL compared to those with a CD4 count of 750–999 cells/µL, but did not decrease further at higher CD4 counts. Results were similar in patients virologically suppressed on combination antiretroviral therapy, suggesting that immune reconstitution is not complete until the CD4 increases to >750 cells/µL.

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Title: The Incidence of AIDS-Defining Illnesses at a Current CD4 Count ≥200 Cells/µL in the Post–Combination Antiretroviral Therapy Era
Creators - without role: Amanda Mocroft - University College London
H J Furrer - University Hospital of Bern
J M Miro - Université de Montpellier, Physiologie et Médecine Expérimentale du coeur et des muscles - PhyMedExp
P. Reiss - Academic Medical Center
C. Mussini - University of Modena and Reggio Emilia
O. Kirk - Copenhagen University Hospital
Sophie Abgrall - Sorbonne Université
S. Ayayi - Inserm
B. Bartmeyer - Robert Koch Institute
D. Braun - University Hospital of Zurich
A. Castagna - Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele
A. d'Arminio Monforte - San Paolo Hospital
B. Gazzard - Chelsea and Westminster Hospital
F. Gutierrez - Universitat de Miguel Hernández d'Elx
I. Hurtado - Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana
K. Jansen - Ruhr University Bochum
L. Meyer - Centre de recherche en Epidémiologie et Santé des Populations
P. Muñoz - Hospital de Basurto
N. Obel - Copenhagen University Hospital
P. Soler-Palacin - Universitat Autònoma de Barcelona
A. Papadopoulos - University General Hospital Attikon
F. Raffi - Centre d'Investigation Clinique de Nantes
J T Ramos - Hospital Universitario de Getafe
J K Rockstroh - University Hospital Bonn
D. Salmon - Hôpital Cochin
C. Torti - Magna Graecia University
J. Warszawski - Inserm
S. de Wit - Université Libre de Bruxelles
R. Zangerle - Innsbruck Medical University
C. Fabre-Colin - Inserm
J. Kjaer - Geological Survey of Denmark and Greenland
G. Chene - Bordeaux Population Health
J. Grarup
J D Lundgren - Copenhagen University Hospital
Amanda Mocroft - University College London
Hansjakob Furrer - University Hospital of Bern
Jose Miro - Université de Montpellier, Physiologie et Médecine Expérimentale du coeur et des muscles - PhyMedExp
Peter Reiss - Academic Medical Center
Cristina Mussini - University of Modena and Reggio Emilia
Ole Kirk - Copenhagen University Hospital
Sophie Abgrall - Sorbonne Université
Sylvie Ayayi - Inserm
Barbara Bartmeyer - Robert Koch Institute
Dominique Braun - University Hospital of Zurich
Antonella Castagna - Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele
Antonella d'Arminio Monforte - San Paolo Hospital
Brian Gazzard - Chelsea and Westminster Hospital
Félix Gutierrez - Universitat de Miguel Hernández d'Elx
Isabel Hurtado - Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana
Klaus Jansen - Ruhr University Bochum
Laurence Meyer - Centre de recherche en Epidémiologie et Santé des Populations
Pepa Muñoz - Hospital de Basurto
Niels Obel - Copenhagen University Hospital
Pere Soler-Palacin - Universitat Autònoma de Barcelona
Antonios Papadopoulos - University General Hospital Attikon
François Raffi - Centre d'Investigation Clinique de Nantes
Jose Ramos - Hospital Universitario de Getafe
Jürgen Rockstroh - University Hospital Bonn
Dominique Salmon - Hôpital Cochin
Carlo Torti - Magna Graecia University
Josianne Warszawski - Inserm
Stephane de Wit
Robert Zangerle - Innsbruck Medical University
Céline Fabre-Colin - Inserm
Jesper Kjaer
Genevieve Chene - Bordeaux Population Health
Jesper Grarup
Jens Lundgren - Copenhagen University Hospital
Jens Lundgren - Copenhagen University Hospital
Jose Miiro
Pere Soler Palacin
Carolo Torti - Magna Graecia University
Josiane Warszawski - Inserm
Jurgen Rockstroh - University Hospital Bonn
José Ramos - Hospital Universitario de Getafe
Jose Miró - Université de Montpellier, Physiologie et Médecine Expérimentale du coeur et des muscles - PhyMedExp
Pepa Munoz - Hospital de Basurto
Ali Judd
Josiane Warszawski - Inserm
David Haerry
Ian Weller
Jordi Casabona
Dominique Costagliola
Antonella d'Arminio-Monforte
Manuel Battegay
Maria Prins
Frank de Wolf
Céline Colin - Inserm
Christine Schwimmer
Guillaume Touzeau
Maria Campbell
Julia Bohlius
Vincent Bouteloup
Heiner Bucher
Alessandro Cozzi-Lepri
François Dabis
Maria Dorrucci
Matthias Egger
Frederik Engsig
Olivier Lambotte
Charlotte Lewden
Rebecca Lodwick
Sophie Matheron
Jose Miro - Université de Montpellier, Physiologie et Médecine Expérimentale du coeur et des muscles - PhyMedExp
Roger Paredes
Andrew Phillips
Massimo Puoti
Joanne Reekie
Caroline Sabin
Alexandra Scherrer
Colette Smit
Jonathan Sterne
Rodolphe Thiebaut
Claire Thorne
Viktor von Wyl
Linda Wittkop
Jim Young
Publication Details: Clinical Infectious Diseases, Vol.57(7), pp.1038-1047
Identifiers: 9941432209311
Academic Unit: Physiologie et Médecine Expérimentale du coeur et des muscles - PhyMedExp
Language: English
Resource Type: Dataset
Local Fields: hal-05078210