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

Linda Wittkop, Julie Arsandaux, Ana Trevino, Maarten Schim van der Loeff, Jane Anderson, Ard van Sighem, Jürg Böni, Françoise Brun-Vezinet, Vicente Soriano, Faroudy Boufassa, Norbert Brockmeyer, Alexandra Calmy, François Dabis, Inma Jarrin, Maria Dorrucci, Vitor Duque, Gerd Fätkenheuer, Robert Zangerle, Elena Ferrer, Kholoud PorterAli Judd, Nikolaos V Sipsas, Olivier Lambotte, Leah Shepherd, Catherine Leport, Charles Morrison, Cristina Mussini, Niels Obel, Jean Ruelle, Carolyne Schwarze-Zander, Anders Sonnerborg, Ramon Teira, Carlo Torti, Emilia Valadas, Celine Colin, Nina Friis-Møller, Dominique Costagliola, Rodolphe Thiebaut, Geneviève Chene, Sophie Matheron, COHERE in EuroCoord and ACHIeV2e Study Group

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15 Citationer (Scopus)

Abstract

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.

OriginalsprogEngelsk
TidsskriftThe Journal of antimicrobial chemotherapy
Vol/bind72
Udgave nummer10
Sider (fra-til)2869-2878
ISSN0305-7453
DOI
StatusUdgivet - 2017

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