Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy

Tuan Le, Edwina Jane Wright, Davey M Smith, Weijing He, Gabriel Catano, Jason Okulicz, Jason A Young, Robert A Clark, Douglas D Richman, Susan J Little, Sunil K Ahuja

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Abstract

BACKGROUND: The relationship between the timing of the initiation of antiretroviral therapy (ART) after infection with human immunodeficiency virus type 1 (HIV-1) and the recovery of CD4+ T-cell counts is unknown. METHODS: In a prospective, observational cohort of persons with acute or early HIV-1 infection, we determined the trajectory of CD4+ counts over a 48-month period in partially overlapping study sets: study set 1 included 384 participants during the time window in which they were not receiving ART and study set 2 included 213 participants who received ART soon after study entry or sometime thereafter and had a suppressed plasma HIV viral load. We investigated the likelihood and rate of CD4+ T-cell recovery to 900 or more cells per cubic millimeter within 48 months while the participants were receiving viral-load-suppressive ART. RESULTS: Among the participants who were not receiving ART, CD4+ counts increased spontaneously, soon after HIV-1 infection, from the level at study entry (median, 495 cells per cubic millimeter; interquartile range, 383 to 622), reached a peak value (median, 763 cells per cubic millimeter; interquartile range, 573 to 987) within approximately 4 months after the estimated date of infection, and declined progressively thereafter. Recovery of CD4+ counts to 900 or more cells per cubic millimeter was seen in approximately 64 of the participants who initiated ART earlier (=4 months after the estimated date of HIV infection) as compared with approximately 34 of participants who initiated ART later (>4 months) (P
Original languageEnglish
Pages (from-to)218 - 230
Number of pages13
JournalNew England Journal of Medicine
Volume368
Issue number3
DOIs
Publication statusPublished - 2013

Cite this

Le, T., Wright, E. J., Smith, D. M., He, W., Catano, G., Okulicz, J., ... Ahuja, S. K. (2013). Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy. New England Journal of Medicine, 368(3), 218 - 230. https://doi.org/10.1056/NEJMoa1110187
Le, Tuan ; Wright, Edwina Jane ; Smith, Davey M ; He, Weijing ; Catano, Gabriel ; Okulicz, Jason ; Young, Jason A ; Clark, Robert A ; Richman, Douglas D ; Little, Susan J ; Ahuja, Sunil K. / Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy. In: New England Journal of Medicine. 2013 ; Vol. 368, No. 3. pp. 218 - 230.
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abstract = "BACKGROUND: The relationship between the timing of the initiation of antiretroviral therapy (ART) after infection with human immunodeficiency virus type 1 (HIV-1) and the recovery of CD4+ T-cell counts is unknown. METHODS: In a prospective, observational cohort of persons with acute or early HIV-1 infection, we determined the trajectory of CD4+ counts over a 48-month period in partially overlapping study sets: study set 1 included 384 participants during the time window in which they were not receiving ART and study set 2 included 213 participants who received ART soon after study entry or sometime thereafter and had a suppressed plasma HIV viral load. We investigated the likelihood and rate of CD4+ T-cell recovery to 900 or more cells per cubic millimeter within 48 months while the participants were receiving viral-load-suppressive ART. RESULTS: Among the participants who were not receiving ART, CD4+ counts increased spontaneously, soon after HIV-1 infection, from the level at study entry (median, 495 cells per cubic millimeter; interquartile range, 383 to 622), reached a peak value (median, 763 cells per cubic millimeter; interquartile range, 573 to 987) within approximately 4 months after the estimated date of infection, and declined progressively thereafter. Recovery of CD4+ counts to 900 or more cells per cubic millimeter was seen in approximately 64 of the participants who initiated ART earlier (=4 months after the estimated date of HIV infection) as compared with approximately 34 of participants who initiated ART later (>4 months) (P",
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Le, T, Wright, EJ, Smith, DM, He, W, Catano, G, Okulicz, J, Young, JA, Clark, RA, Richman, DD, Little, SJ & Ahuja, SK 2013, 'Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy', New England Journal of Medicine, vol. 368, no. 3, pp. 218 - 230. https://doi.org/10.1056/NEJMoa1110187

Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy. / Le, Tuan; Wright, Edwina Jane; Smith, Davey M; He, Weijing; Catano, Gabriel; Okulicz, Jason; Young, Jason A; Clark, Robert A; Richman, Douglas D; Little, Susan J; Ahuja, Sunil K.

In: New England Journal of Medicine, Vol. 368, No. 3, 2013, p. 218 - 230.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Le, Tuan

AU - Wright, Edwina Jane

AU - Smith, Davey M

AU - He, Weijing

AU - Catano, Gabriel

AU - Okulicz, Jason

AU - Young, Jason A

AU - Clark, Robert A

AU - Richman, Douglas D

AU - Little, Susan J

AU - Ahuja, Sunil K

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