Lee SS, et al. - An observational cohort study is performed to evaluate immune recovery by incorporating both CD4 count and CD4:CD8 ratio. A combination of CD4 count and CD4:CD8 ratio could be a helpful approach for the characterisation of treatment outcome over time, on top of monitoring CD4 count alone.

Methods

• For this study, they conducted an observational cohort study.
• In this study, they evaluated the clinical data from Chinese HIV-positive patients attending the largest HIV service in Hong Kong and who had been on HAART for ≥4 years.

Results

• In this study, a total of 718 patients were incorporated for examination (6353 person-years).
• At the end of year 4,318 out of 715 patients achieved CD4 ≥500/μL, of which only 33% (105 out of 318) concurrently achieved CD4:CD8 ratio ≥ 0.8.
• Patients with a pre-HAART CD8 ≤ 800/μL (428 out of 704) were more likely to be optimal immune outcome achievers with CD4 ≥ 500/μL and CD4:CD8 ratio ≥0.8, the relationship of which was stronger after adjusting for pre-HAART CD4 counts.
• In a multivariable logistic model, optimal immune outcome was positively related to male gender, younger pre-HAART age and higher pre-HAART CD4 count, longer duration of HAART and pre-HAART CD8 ≤800/μL.
• Treatment regimen and cumulative viral loads played no important role in the pattern of immune recovery.