Setting a minimum threshold CD4 count for initiation of highly active antiretroviral therapy in HIV-infected patients
Publication in refereed journal

Times Cited
Web of Science8WOS source URL (as at 29/10/2020) Click here for the latest count
Altmetrics Information

Other information
AbstractThe aim of our study was to determine a minimum threshold CD4 count for highly active antiretroviral therapy (HAART) initiation in HIV-infected patients. A schema using longitudinal data from a clinical cohort was designed. The presenting CD4 counts of asymptomatic HIV-infected patients in Hong Kong were evaluated in relation to their progression to AIDS within 1 year of diagnosis of HIV infection. A graph was generated to depict the changes in the percentage of cumulative AIDS diagnoses for every 10 cell/mu L increase in presenting CD4 count. Of 181 patients, 24 had developed AIDS within 1 year of diagnosis of HIV infection. Setting the CD4 count threshold at 150 cells/mu L gave a good balance between the number of preventable AIDS-defining events and the number of non-AIDS patients initiating HAART. No extra AIDS-defining events occurred when the CD4 count threshold was reduced from 200 to 150 cells/mu L, despite the addition of 13 more patients. In multivariate Cox regression analysis, presenting CD4 count was a significant predictor for AIDS occurrence. The relative hazard for AIDS occurrence of patients with presenting CD4 counts <= 150 cells/mu L was 27-fold greater. We suggest a CD4 count of 150 cells/mu L as the minimum threshold for HAART initiation in a cohort of Chinese HIV-infected patients. At this level, 20.8% of the AIDS-defining events could be prevented. While a cut-off of 200 cells/mu L remains a standard for considering HAART initiation, the minimum threshold signifies a critical moment for timely intervention to be introduced.
All Author(s) ListHo CF, Lee SS, Wong KH, Cheng LS, Lam MY
Journal nameHIV Medicine
Volume Number8
Issue Number3
Pages181 - 185
LanguagesEnglish-United Kingdom
KeywordsCD4 threshold; Chinese HIV-infected patients; HAART
Web of Science Subject CategoriesInfectious Diseases; INFECTIOUS DISEASES

Last updated on 2020-30-10 at 00:56