201. The benefit of immediate compared with deferred antiretroviral therapy on CD4+ cell count recovery in early HIV infection
- Author
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Shweta Sharma, Giuseppe Tambussi, Katherine E. Schlusser, Julia A. Metcalf, Rika Draenert, Oliver Laeyendecker, Pola de la Torre, James D. Neaton, and Angie N Pinto
- Subjects
0301 basic medicine ,medicine.medical_specialty ,business.industry ,Art initiation ,Immunology ,Human immunodeficiency virus (HIV) ,medicine.disease_cause ,medicine.disease ,Antiretroviral therapy ,Serology ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Antiretroviral treatment ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Cd4 cell count ,business ,CD8 - Abstract
OBJECTIVE To assess the impact of immediate vs. deferred antiretroviral therapy (ART) on CD4 recovery among individuals early in HIV infection. DESIGN Using serologic markers of early infection together with self-reported dates of infection and HIV diagnosis, ART-naive participants who were randomized to immediate vs. deferred ART in the Strategic Timing of Antiretroviral Treatment trial were classified into subgroups of duration of HIV infection at baseline. CD4 cell count recovery over follow-up according to duration of HIV infection was investigated. METHODS Three subgroups were defined: first, infected 6 months or less (n = 373); second, infected 6-24 months (n = 2634); and third, infected 24 months or longer (n = 1605). Follow-up CD4, CD8, and CD4 : CD8 ratio for the immediate and deferred ART groups were compared by subgroup using linear models. For the deferred ART group, decline to CD4 less than 350 cells/μl or AIDS according to infection duration was compared using time-to-event methods. RESULTS Follow-up CD4 cell count differences (immediate minus deferred) were greater for those recently infected (+231 cells/μl) compared with the two other subgroups (202 and 171 cells/μl; P
- Published
- 2019