Poor CD4 response despite viral suppression is associated with increased non-AIDS related mortality among HIV patients and their parents
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Poor CD4 response despite viral suppression is associated with increased non-AIDS related mortality among HIV patients and their parents. / Helleberg, Marie; Kronborg, Gitte; Larsen, Carsten; Pedersen, Gitte; Pedersen, Court; Obel, Niels; Gerstoft, Jan.
In: AIDS, 2013.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Poor CD4 response despite viral suppression is associated with increased non-AIDS related mortality among HIV patients and their parents
AU - Helleberg, Marie
AU - Kronborg, Gitte
AU - Larsen, Carsten
AU - Pedersen, Gitte
AU - Pedersen, Court
AU - Obel, Niels
AU - Gerstoft, Jan
PY - 2013
Y1 - 2013
N2 - INTRODUCTION:: poor CD4 response to antiretroviral treatment (HAART) is associated with increased mortality. We analyzed the impact of CD4 increase on non-AIDS related morbidity and on mortality in HIV patients and their parents. METHODS:: mortality rates were estimated among 1,758 virally suppressed patients in the Danish HIV Cohort Study after two years on HAART and among their parents (n=1,603). Analyses were stratified by pre-HAART CD4 count and CD4 increase. Incidence rate ratios of non-AIDS-related morbidity and mortality rate ratios (MRR) were analyzed using Poisson regression. RESULTS:: CD4 increases 100 cells/μL was associated with increased mortality (MRR 3.5 (95%CI 1.8-6.8)) even in individuals with pre-HAART CD4>250 cells/μ (MRR 3.2 (95%CI 1.3-7.8). Mortality of parents of patients with poor CD4 response was also increased (MRR 1.5 (95%CI 1.1-2.1)). There was a trend towards association between poor CD4 response and increased risk of cardiovascular disease and cancer (IRR 1.6 (95%CI 0.8-3.2) and 1.6 (95%CI 0.6-4.8)). CONCLUSIONS:: poor CD4 increase after HAART is associated with adverse prognosis even in absence of severe immunosuppression. CD4 response in HIV patients is associated with mortality among their parents, thus poor CD4 response may be caused by genetic factors, which might also affect morbidity and mortality in the HIV negative population.
AB - INTRODUCTION:: poor CD4 response to antiretroviral treatment (HAART) is associated with increased mortality. We analyzed the impact of CD4 increase on non-AIDS related morbidity and on mortality in HIV patients and their parents. METHODS:: mortality rates were estimated among 1,758 virally suppressed patients in the Danish HIV Cohort Study after two years on HAART and among their parents (n=1,603). Analyses were stratified by pre-HAART CD4 count and CD4 increase. Incidence rate ratios of non-AIDS-related morbidity and mortality rate ratios (MRR) were analyzed using Poisson regression. RESULTS:: CD4 increases 100 cells/μL was associated with increased mortality (MRR 3.5 (95%CI 1.8-6.8)) even in individuals with pre-HAART CD4>250 cells/μ (MRR 3.2 (95%CI 1.3-7.8). Mortality of parents of patients with poor CD4 response was also increased (MRR 1.5 (95%CI 1.1-2.1)). There was a trend towards association between poor CD4 response and increased risk of cardiovascular disease and cancer (IRR 1.6 (95%CI 0.8-3.2) and 1.6 (95%CI 0.6-4.8)). CONCLUSIONS:: poor CD4 increase after HAART is associated with adverse prognosis even in absence of severe immunosuppression. CD4 response in HIV patients is associated with mortality among their parents, thus poor CD4 response may be caused by genetic factors, which might also affect morbidity and mortality in the HIV negative population.
U2 - 10.1097/QAD.0b013e32835cba4c
DO - 10.1097/QAD.0b013e32835cba4c
M3 - Journal article
C2 - 23196936
JO - AIDS
JF - AIDS
SN - 1350-2840
ER -
ID: 48451476