1. Current and Past Immunodeficiency Are Associated With Higher Hospitalization Rates Among Persons on Virologically Suppressive Antiretroviral Therapy for up to 11 Years
- Author
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Davy-Mendez, Thibaut, Napravnik, Sonia, Eron, Joseph J, Cole, Stephen R, van Duin, David, Wohl, David A, Hogan, Brenna C, Althoff, Keri N, Gebo, Kelly A, Moore, Richard D, Silverberg, Michael J, Horberg, Michael A, Gill, M John, Mathews, W Christopher, Klein, Marina B, Colasanti, Jonathan A, Sterling, Timothy R, Mayor, Angel M, Rebeiro, Peter F, Buchacz, Kate, Li, Jun, Nanditha, Ni Gusti Ayu, Thorne, Jennifer E, Nijhawan, Ank, Berry, Stephen A, Benson, Constance A, Bosch, Ronald J, Kirk, Gregory D, Mayer, Kenneth H, Grasso, Chris, Hogg, Robert S, Montaner, Julio SG, Salters, Kate, Lima, Viviane D, Sereda, Paul, Trigg, Jason, Rodriguez, Benigno, Brown, Todd, Tien, Phyllis, D’Souza, Gypsyamber, Rabkin, Charles, Kroch, Abigail, Burchell, Ann, Betts, Adrian, Lindsay, oanne, Hunter-Mellado, Robert F, Martin, Jeffrey N, Brooks, John T, Saag, Michael S, Mugavero, Michael J, Willig, James, Mathews, William C, Kitahata, Mari M, Crane, Heidi M, Haas, David, Rebeiro, Peter, Turner, Megan, Tate, Janet, Dubrow, Robert, Fiellin, David, Gange, Stephen J, McKaig, Rosemary G, Freeman, Aimee M, Van Rompaey, Stephen E, Morton, Liz, McReynolds, Justin, Lober, William B, Lee, Jennifer S, You, Bin, Hogan, Brenna, Zhang, Jinbing, and Jing, Jerry
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,Sexually Transmitted Infections ,Clinical Research ,Anti-HIV Agents ,CD4 Lymphocyte Count ,Canada ,Cohort Studies ,Female ,HIV Infections ,Hospitalization ,Humans ,Male ,Viral Load ,HIV/AIDS ,6.1 Pharmaceuticals ,HIV ,hospitalization ,CD4 lymphocyte count ,sustained virologic response ,cohort studies ,North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Biological sciences ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundPersons with HIV (PWH) with persistently low CD4 counts despite efficacious antiretroviral therapy could have higher hospitalization risk.MethodsIn six US and Canadian clinical cohorts, PWH with virologic suppression for ≥1 year in 2005-2015 were followed until virologic failure, loss to follow-up, death, or study end. Stratified by early (Years 2-5) and long-term (Years 6-11) suppression and lowest pre-suppression CD4 count 500 cells/μL had an aIRR of 1.44 during early suppression (95% CI 1.01-2.06), and 1.67 (1.03-2.72) during long-term suppression. Among patients with lowest pre-suppression CD4 ≥200 (56%), patients with current CD4 351-500 versus >500 cells/μL had an aIRR of 1.22 (0.93-1.60) during early suppression and 2.09 (1.18-3.70) during long-term suppression.ConclusionsVirologically suppressed patients with lower CD4 counts experienced higher hospitalization rates, and could potentially benefit from targeted clinical management strategies.
- Published
- 2021