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CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients: a multinational, multicohort European study

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  • Linda Wittkop
  • Julie Arsandaux
  • Ana Trevino
  • Maarten Schim van der Loeff
  • Jane Anderson
  • Ard van Sighem
  • Jürg Böni
  • Françoise Brun-Vezinet
  • Vicente Soriano
  • Faroudy Boufassa
  • Norbert Brockmeyer
  • Alexandra Calmy
  • François Dabis
  • Inma Jarrin
  • Maria Dorrucci
  • Vitor Duque
  • Gerd Fätkenheuer
  • Robert Zangerle
  • Elena Ferrer
  • Kholoud Porter
  • Ali Judd
  • Nikolaos V Sipsas
  • Olivier Lambotte
  • Leah Shepherd
  • Catherine Leport
  • Charles Morrison
  • Cristina Mussini
  • Niels Obel
  • Jean Ruelle
  • Carolyne Schwarze-Zander
  • Anders Sonnerborg
  • Ramon Teira
  • Carlo Torti
  • Emilia Valadas
  • Celine Colin
  • Nina Friis-Møller
  • Dominique Costagliola
  • Rodolphe Thiebaut
  • Geneviève Chene
  • Sophie Matheron
  • COHERE in EuroCoord and ACHIeV2e Study Group
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Background: CD4 cell recovery following first-line combination ART (cART) is poorer in HIV-2+ than in HIV-1+ patients. Only large comparisons may allow adjustments for demographic and pretreatment plasma viral load (pVL).

Methods: ART-naive HIV+ adults from two European multicohort collaborations, COHERE (HIV-1 alone) and ACHIeV2e (HIV-2 alone), were included, if they started first-line cART (without NNRTIs or fusion inhibitors) between 1997 and 2011. Patients without at least one CD4 cell count before start of cART, without a pretreatment pVL and with missing a priori-defined covariables were excluded. Evolution of CD4 cell count was studied using adjusted linear mixed models.

Results: We included 185 HIV-2+ and 30321 HIV-1+ patients with median age of 46 years (IQR 36-52) and 37 years (IQR 31-44), respectively. Median observed pretreatment CD4 cell counts/mm3 were 203 (95% CI 100-290) in HIV-2+ patients and 223 (95% CI 100-353) in HIV-1+ patients. Mean observed CD4 cell count changes from start of cART to 12 months were +105 (95% CI 77-134) in HIV-2+ patients and +202 (95% CI 199-205) in HIV-1+ patients, an observed difference of 97 cells/mm3 in 1 year. In adjusted analysis, the mean CD4 cell increase was overall 25 CD4 cells/mm3/year lower (95% CI 5-44; P = 0.0127) in HIV-2+ patients compared with HIV-1+ patients.

Conclusions: A poorer CD4 cell increase during first-line cART was observed in HIV-2+ patients, even after adjusting for pretreatment pVL and other potential confounders. Our results underline the need to identify more potent therapeutic regimens or strategies against HIV-2.

Original languageEnglish
JournalThe Journal of antimicrobial chemotherapy
Volume72
Issue number10
Pages (from-to)2869-2878
Number of pages10
ISSN0305-7453
DOIs
Publication statusPublished - 1 Oct 2017

    Research areas

  • Journal Article

ID: 52618677