Résumé
To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm(3) (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was similar to 421 cells/mm(3) (95% CI = 390; 454) in patients with < 200 cells/mm(3) at baseline and similar to 500 cells/mm(3) in patients with > 200 cells/mm(3). The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm(3) at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment.