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

TY - JOUR

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 - Wittkop, Linda

AU - Arsandaux, Julie

AU - Trevino, Ana

AU - Schim van der Loeff, Maarten

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 - COHERE in EuroCoord and ACHIeV2e Study Group

N1 - © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: [email protected].

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 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.

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 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.

U2 - 10.1093/jac/dkx210

DO - 10.1093/jac/dkx210

M3 - Journal article

C2 - 29091198

SN - 0305-7453

VL - 72

SP - 2869

EP - 2878

JO - The Journal of antimicrobial chemotherapy

JF - The Journal of antimicrobial chemotherapy

IS - 10

ER -