CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients

A multinational, multicohort European study

n behalf of the COHERE in EuroCoord and ACHIeV2e Study Group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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 12months 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
Pages (from-to)2869-2878
Number of pages10
JournalJournal of Antimicrobial Chemotherapy
Volume72
Issue number10
DOIs
Publication statusPublished - Oct 1 2017

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HIV-2
CD4 Lymphocyte Count
HIV-1
Viral Load
Linear Models
Demography
HIV

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients : A multinational, multicohort European study. / n behalf of the COHERE in EuroCoord and ACHIeV2e Study Group.

In: Journal of Antimicrobial Chemotherapy, Vol. 72, No. 10, 01.10.2017, p. 2869-2878.

Research output: Contribution to journalArticle

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title = "CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients: A multinational, multicohort European study",
abstract = "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 12months 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.",
author = "{n behalf of the COHERE in EuroCoord and ACHIeV2e Study Group} and Linda Wittkop and Julie Arsandaux and Ana Trevino and {van der Loeff}, {Maarten Schim} and Jane Anderson and {van Sighem}, Ard and J{\"u}rg B{\"o}ni and Fran{\cc}oise Brun-Vezinet and Vicente Soriano and Faroudy Boufassa and Norbert Brockmeyer and Alexandra Calmy and Fran{\cc}ois Dabis and Inma Jarrin and Maria Dorrucci and Vitor Duque and Gerd F{\"a}tkenheuer and Robert Zangerle and Elena Ferrer and Kholoud Porter and Ali Judd and Sipsas, {Nikolaos V.} and Olivier Lambotte and Leah Shepherd and Catherine Leport and Charles Morrison and Cristina Mussini and Niels Obel and Jean Ruelle and Carolyne Schwarze-Zander and Anders Sonnerborg and Ramon Teira and Carlo Torti and Emilia Valadas and Celine Colin and Nina Friis-M{\o}ller and Dominique Costagliola and Rodolphe Thiebaut and Genevi{\`e}ve Chene and Sophie Matheron and Giota Touloumi and Josiane Warszawski and Laurence Meyer and Krause, {Murielle Mary} and Jade Ghosn and Peter Reiss and Ferdinand Wit and Maria Prins and Andrea Antinori and Antonella Castagna",
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T1 - CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients

T2 - A multinational, multicohort European study

AU - n behalf of the COHERE in EuroCoord and ACHIeV2e Study Group

AU - Wittkop, Linda

AU - Arsandaux, Julie

AU - Trevino, Ana

AU - van der Loeff, Maarten Schim

AU - Anderson, Jane

AU - van Sighem, Ard

AU - Böni, Jürg

AU - Brun-Vezinet, Françoise

AU - Soriano, Vicente

AU - Boufassa, Faroudy

AU - Brockmeyer, Norbert

AU - Calmy, Alexandra

AU - Dabis, François

AU - Jarrin, Inma

AU - Dorrucci, Maria

AU - Duque, Vitor

AU - Fätkenheuer, Gerd

AU - Zangerle, Robert

AU - Ferrer, Elena

AU - Porter, Kholoud

AU - Judd, Ali

AU - Sipsas, Nikolaos V.

AU - Lambotte, Olivier

AU - Shepherd, Leah

AU - Leport, Catherine

AU - Morrison, Charles

AU - Mussini, Cristina

AU - Obel, Niels

AU - Ruelle, Jean

AU - Schwarze-Zander, Carolyne

AU - Sonnerborg, Anders

AU - Teira, Ramon

AU - Torti, Carlo

AU - Valadas, Emilia

AU - Colin, Celine

AU - Friis-Møller, Nina

AU - Costagliola, Dominique

AU - Thiebaut, Rodolphe

AU - Chene, Geneviève

AU - Matheron, Sophie

AU - Touloumi, Giota

AU - Warszawski, Josiane

AU - Meyer, Laurence

AU - Krause, Murielle Mary

AU - Ghosn, Jade

AU - Reiss, Peter

AU - Wit, Ferdinand

AU - Prins, Maria

AU - Antinori, Andrea

AU - Castagna, Antonella

PY - 2017/10/1

Y1 - 2017/10/1

N2 - 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 12months 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.

AB - 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 12months 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.

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U2 - 10.1093/jac/dkx210

DO - 10.1093/jac/dkx210

M3 - Article

VL - 72

SP - 2869

EP - 2878

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 10

ER -