Treatment in Primary HIV Infection Is Significantly More Likely to Normalize CD4:CD8 Ratio
August 9, 2016
Starting ART in primary compared to chronic HIV infection had a significantly higher chance of getting a CD4:CD8 ratio >1.0 in a retrospective study in which individuals were their own controls.
This was a retrospective analysis by from Alexander Pasternak from University of Amsterdam and colleagues of 48 people who started a temporary period of ART in primary infection (PHI) -- for either 24 or 60 weeks -- and who after a median time of 2.4 years off-ART, subsequently restarted treatment again during chronic HIV infection (CHI).
As would be expected, the median CD4 count was higher at baseline for the PHI compared to CHI periods: 505 (IQR: 303 to 713) vs 310 (245 to 418) cells/mm3 respectively (p< 0.0001).
However, there no difference in the dynamics of CD4 recovery between the PHI and CHI follow-up periods with median CD4 increases of 210 cells/mm3 at week-60 for both groups (although the PHI response reached higher absolute CD4 levels).
Although there was no significant differences between the CD4:CD8 ratio in the PHI vs CHI groups at baseline (0.48 (0.25-0.80) compared to 0.36 (0.25-0.41), respectively; p>0.05), there were significantly different increases in the CD4:CD8 ratio.
By week-12 this ratio increased to 0.95 (0.74 to 1.29) compared to 0.52 (0.41 to 0.74) in the PHI vs CHI periods respectively (p< 0.0001). The differences were sustained to week-48 with 59% compared to 29% of participants achieving a CD4:CD8 ratio > 1.0 (p=0.0049) in the PHI vs CHI periods respectively.
Pasternak A et al. Faster restoration of CD4:CD8 ratio during the first 12 weeks of ART initiated at early HIV infection compared with ART initiated at chronic infection in the same patients. THPEB033.
This article was provided by HIV i-Base. It is a part of the publication HIV Treatment Bulletin. Visit HIV i-Base's website to find out more about their activities, publications and services.
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