Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study
Abstract Current WHO guidelines recommend initiating ART regardless of CD4+ cell count. In response, we conducted an observational cohort study to assess the effects of pre-ART CD4+ cell count levels on death, attrition, and death or attrition in HIV treated patients. This large HIV treatment cohort...
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Nature Portfolio
2017
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oai:doaj.org-article:aee522c20f9f4f2a9206f2a1af80794d2021-12-02T11:52:44ZEffects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study10.1038/s41598-017-03384-72045-2322https://doaj.org/article/aee522c20f9f4f2a9206f2a1af80794d2017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03384-7https://doaj.org/toc/2045-2322Abstract Current WHO guidelines recommend initiating ART regardless of CD4+ cell count. In response, we conducted an observational cohort study to assess the effects of pre-ART CD4+ cell count levels on death, attrition, and death or attrition in HIV treated patients. This large HIV treatment cohort study (n = 49,155) from 2010 to 2015 was conducted in Guangxi, China. We used a Cox regression model to analyze associations between pre-ART CD4+ cell counts and death, attrition, and death or attrition. The average mortality and ART attrition rates among all treated patients were 2.63 deaths and 5.32 attritions per 100 person-years, respectively. Compared to HIV patients with <350 CD4+ cells/mm3 at ART initiation, HIV patients with >500 CD4+ cells/mm3 at ART initiation had a significantly lower mortality rate (Adjusted hazard ratio: 0.56, 95% CI: 0.40–0.79), but significantly higher ART attrition rate (AHR: 1.17, 95% CI: 1.03–1.33). Results from this study suggest that HIV patients with high CD4+ cell counts at the time of ART initiation may be at greater risk of treatment attrition. To further reduce ART attrition, it is imperative that patient education and healthcare provider training on ART adherence be enhanced and account for CD4 levels at ART initiation.Zhenzhu TangStephen W. PanYuhua RuanXuanhua LiuJinming SuQiuying ZhuZhiyong ShenHeng ZhangYi ChenGuanghua LanHui XingLingjie LiaoYi FengYiming ShaoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017) |
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Medicine R Science Q |
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Medicine R Science Q Zhenzhu Tang Stephen W. Pan Yuhua Ruan Xuanhua Liu Jinming Su Qiuying Zhu Zhiyong Shen Heng Zhang Yi Chen Guanghua Lan Hui Xing Lingjie Liao Yi Feng Yiming Shao Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| description |
Abstract Current WHO guidelines recommend initiating ART regardless of CD4+ cell count. In response, we conducted an observational cohort study to assess the effects of pre-ART CD4+ cell count levels on death, attrition, and death or attrition in HIV treated patients. This large HIV treatment cohort study (n = 49,155) from 2010 to 2015 was conducted in Guangxi, China. We used a Cox regression model to analyze associations between pre-ART CD4+ cell counts and death, attrition, and death or attrition. The average mortality and ART attrition rates among all treated patients were 2.63 deaths and 5.32 attritions per 100 person-years, respectively. Compared to HIV patients with <350 CD4+ cells/mm3 at ART initiation, HIV patients with >500 CD4+ cells/mm3 at ART initiation had a significantly lower mortality rate (Adjusted hazard ratio: 0.56, 95% CI: 0.40–0.79), but significantly higher ART attrition rate (AHR: 1.17, 95% CI: 1.03–1.33). Results from this study suggest that HIV patients with high CD4+ cell counts at the time of ART initiation may be at greater risk of treatment attrition. To further reduce ART attrition, it is imperative that patient education and healthcare provider training on ART adherence be enhanced and account for CD4 levels at ART initiation. |
| format |
article |
| author |
Zhenzhu Tang Stephen W. Pan Yuhua Ruan Xuanhua Liu Jinming Su Qiuying Zhu Zhiyong Shen Heng Zhang Yi Chen Guanghua Lan Hui Xing Lingjie Liao Yi Feng Yiming Shao |
| author_facet |
Zhenzhu Tang Stephen W. Pan Yuhua Ruan Xuanhua Liu Jinming Su Qiuying Zhu Zhiyong Shen Heng Zhang Yi Chen Guanghua Lan Hui Xing Lingjie Liao Yi Feng Yiming Shao |
| author_sort |
Zhenzhu Tang |
| title |
Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| title_short |
Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| title_full |
Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| title_fullStr |
Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| title_full_unstemmed |
Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study |
| title_sort |
effects of high cd4 cell counts on death and attrition among hiv patients receiving antiretroviral treatment: an observational cohort study |
| publisher |
Nature Portfolio |
| publishDate |
2017 |
| url |
https://doaj.org/article/aee522c20f9f4f2a9206f2a1af80794d |
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