Better virological outcomes among people living with human immunodeficiency virus (HIV) initiating early antiretroviral Tteatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) trial in South Africa

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dc.contributor.authorFatti, Geoffreyen_ZA
dc.contributor.authorGrimwood, Ashrafen_ZA
dc.contributor.authorNachega, Jean B.en_ZA
dc.contributor.authorNelson, Jenna A.en_ZA
dc.contributor.authorLaSorda, Kelseaen_ZA
dc.contributor.authorvan Zyl, Gerten_ZA
dc.contributor.authorGrobbelaar, Nelisen_ZA
dc.contributor.authorAyles, Helenen_ZA
dc.contributor.authorHayes, Richarden_ZA
dc.contributor.authorBeyers, Nuldaen_ZA
dc.contributor.authorFidler, Sarahen_ZA
dc.contributor.authorBock, Peteren_ZA
dc.date.accessioned2022-06-01T10:24:16Z
dc.date.available2022-06-01T10:24:16Z
dc.date.issued2020-01-16
dc.descriptionCITATION: Fatti, G. et al. 2020. Better virological outcomes among people living with human immunodeficiency virus (HIV) initiating early antiretroviral Tteatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) trial in South Africa. Clinical infectious diseases, 70(3):395–403. doi:10.1093/cid/ciz214
dc.descriptionThe original publication is available at https://academic.oup.com/cid/
dc.description.abstractBackground: There have been concerns about reduced adherence and human immunodeficiency virus (HIV) virological suppression (VS) among clinically well people initiating antiretroviral therapy (ART) with high pre-ART CD4 cell counts. We compared virological outcomes by pre-ART CD4 count, where universal ART initiation was provided in the HIV Prevention Trials Network 071 (PopART) trial in South Africa prior to routine national and international implementation. Methods: This prospective cohort study included adults initiating ART at facilities providing universal ART since January 2014. VS (<400 copies/mL), confirmed virological failure (VF) (2 consecutive viral loads >1000 copies/mL), and viral rebound were compared between participants in strata of baseline CD4 cell count. Results: The sample included 1901 participants. VS was ≥94% among participants with baseline CD4 count ≥500 cells/µL at all 6-month intervals to 30 months. The risk of an elevated viral load (≥400 copies/mL) was independently lower among participants with baseline CD4 count ≥500 cells/µL (3.3%) compared to those with CD4 count 200-499 cells/µL (9.2%) between months 18 and 30 (adjusted relative risk, 0.30 [95% confidence interval, .12-.74]; P = .010). The incidence rate of VF was 7.0, 2.0, and 0.5 per 100 person-years among participants with baseline CD4 count <200, 200-499, and ≥500 cells/µL, respectively (P < .0001). VF was independently lower among participants with baseline CD4 count ≥500 cells/µL (adjusted hazard ratio [aHR], 0.23; P = .045) and 3-fold higher among those with baseline CD4 count <200 cells/µL (aHR, 3.49; P < .0001). Conclusions: Despite previous concerns, participants initiating ART with CD4 counts ≥500 cells/µL had very good virological outcomes, being better than those with CD4 counts 200-499 cells/µL. Clinical trials registration: NCT01900977.en_ZA
dc.description.urihttps://pubmed.ncbi.nlm.nih.gov/30877753/
dc.description.versionPublishers version
dc.format.extent9 pages
dc.identifier.citationFatti, G. et al. 2020. Better Virological Outcomes Among People Living With Human Immunodeficiency Virus (HIV) Initiating Early Antiretroviral Treatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) Trial in South Africa. Clinical infectious diseases, 70(3):395–403. doi:10.1093/cid/ciz214
dc.identifier.issn1537-6591 (online)
dc.identifier.issn1058-4838 (print)
dc.identifier.otherdoi:10.1093/cid/ciz214
dc.identifier.urihttp://hdl.handle.net/10019.1/125294
dc.language.isoen_ZAen_ZA
dc.publisherOxford University Press
dc.rights.holderAuthors retain copyright
dc.subjectHIV/AIDSen_ZA
dc.subjectHPTN 071 (PopART) Trialen_ZA
dc.subjectBaseline CD4 cell counten_ZA
dc.subjectEarly antiretroviral treatmenten_ZA
dc.subjectVirological outcomesen_ZA
dc.titleBetter virological outcomes among people living with human immunodeficiency virus (HIV) initiating early antiretroviral Tteatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) trial in South Africaen_ZA
dc.typeArticleen_ZA
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