Scholarlink

Objectives <p>Immune recovery among people living with HIV (PWHIV) receiving antiretroviral therapy (ART) is determined analysing CD4 cell counts and the CD4/CD8 ratio. Recovery to ≥ 800 CD4 cells/µl and CD4/CD8 ratio ≥ 1 was associated with favourable outcomes. We investigated immune recovery over 10 years among ART-naive PWHIV on ART.</p> Methods <p>Data were obtained from two German HIV cohorts, the HIV-1 Seroconverter study and the ClinSurv-HIV study, between 2003 and 2018. We included ART-naïve PWHIV starting with continuous ART and analysed CD4 cell counts and the CD4/CD8 ratio. The time to reaching immune thresholds was investigated using Kaplan–Meier analyses with inverse probability censoring weights.</p> Results <p>Overall, 8,927 participants were included. At baseline, PWHIV had a median CD4 cell count of 257 (interquartile range [IQR] 124–393) cells/µl and CD4/CD8 ratio of 0.26 (IQR 0.14–0.43). After ten years, median CD4 counts increased to 630 (IQR 474–811) cells/µl and CD4/CD8 ratio to 0.84 (IQR 0.61–1.11). PWHIV with higher baseline CD4 values and without viral failure had higher median CD4 counts and CD4/CD8 ratios. The cumulative probability of achieving a CD4 count ≥ 800 cells/µl and/or CD4/CD8 ratio ≥ 1 over 10 years of ART were 54% for the CD4 threshold, 53% for the CD4/CD8 ratio threshold, and 32% for both thresholds. CD4 at baseline was identified as a predictor to achieve immune recovery in all models.</p> Conclusions <p>Early diagnosis and treatment, as well as effective antiviral therapy without viral failure, should be considered to achieve long-term immune recovery among PWHIV.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-term immune recovery under continuous antiretroviral therapy (ART) among ART-naive people living with HIV in two cohorts in Germany

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月26日

查看全文
  • Uwe Koppe,
  • Kirsten Pörtner,
  • Christian Kollan,
  • Annemarie Pantke,
  • Andrea Sailer,
  • Kerstin Dehmel,
  • Stefan Esser,
  • Björn-Erik Ole Jensen,
  • Jürgen Kurt Rockstroh,
  • Guido Schäfer,
  • Dirk Schürmann,
  • Matthias Stoll,
  • Jan-Christian Wasmuth,
  • Tobias Kurth,
  • Barbara Gunsenheimer-Bartmeyer,
  • Heribert Knechten,
  • Petra Panstruga,
  • Caroline Isner,
  • Reinhold Schröder,
  • Hans Wesselmann,
  • Nikolai Menner,
  • Andres Zander,
  • Ulrich Bohr,
  • Heiko Jessen,
  • Arne B. Jessen,
  • Hubert Schulbin,
  • Sascha Brand,
  • Jan Gumprecht,
  • Beate Weninger,
  • Heribert Hillenbrand,
  • Heiko Karcher,
  • Klaus Fischer,
  • Dietmar Schranz,
  • Mathias Vallée,
  • Nicole Gersbacher,
  • Stephan Grunwald,
  • Jörg A. Claus,
  • Claudia Thomas,
  • Roland Grimm,
  • Sarah Schoor,
  • Christiane Cordes,
  • Tobias Glaunsinger,
  • Michael Rausch,
  • Thomas Reineke,
  • Gordon Weinberg,
  • Manuel Bruhy,
  • Siegfried Köppe,
  • Peter Kreckel,
  • Andreas Berger,
  • Sinah Lindemann,
  • Ivanka Krznaric,
  • Norbert H. Brockmeyer,
  • Anja Potthoff,
  • Kathrin van Bremen,
  • Jürgen Rockstroh,
  • Svetlana Hass,
  • Steve Rößler,
  • Martin Hower,
  • Claudia Bachmann,
  • Petra Spornraft-Ragaller,
  • Dieter Teichmann,
  • Falk Hüttig,
  • Cecile Feind,
  • Laura Barkowski,
  • Annette Haberl,
  • Christoph Stephan,
  • Peter Schott,
  • Matthias Müller,
  • Susanne Usadel,
  • Janina Trauth,
  • Alan Chavez-Valladares,
  • Gerd Deutschinoff,
  • Burkhard Kreft,
  • Danica Lange,
  • Olaf Degen,
  • Maher Almahfoud,
  • Peter Buggisch,
  • Sarah Lange,
  • Dorothea Wiemer,
  • Lavinia Biemann,
  • Axel Adam,
  • Thomas Buhk,
  • Stephan Fenske,
  • Stefan Hansen,
  • Christian Hoffmann,
  • Michael Sabranski,
  • Constantin Rickassel,
  • Georg Behrens,
  • Renate Beider,
  • Benjamin T. Schleenvoigt,
  • Mathias W. Pletz,
  • Heinz-August Horst,
  • Silke Trautmann,
  • Ansgar Rieke,
  • Stephan Schneeweiß,
  • Stefan Scholten,
  • Mark Oette,
  • Philipp Schommers,
  • Christian Blumberg,
  • Peter A. Arbter,
  • Thomas Grünewald,
  • Jeannine Weidemann,
  • Ines Ruck,
  • Friederike Neumann,
  • Bernd Claus,
  • Martin Sprinzl,
  • Peter R. Galle,
  • Matthias P. Ebert,
  • Roger Vogelmann,
  • Johannes Bogner,
  • Ulrike Hellerer,
  • Barbara Sonntag,
  • Antoniya Todorova,
  • Claudia Traidl-Hoffmann,
  • Birgit Mück,
  • Ramona Pauli,
  • Christoph D. Spinner,
  • Jochen Schneider,
  • Robert Baumann,
  • Niels Schübel,
  • Christiane Berning,
  • Franz Audebert,
  • Carlos Fritzsche,
  • A. Trein,
  • E. Schnaitmann,
  • Clemens Roll,
  • Simone Marquardt,
  • Georg Härter,
  • Beate Grüner,
  • Cengiz Güler

摘要

Objectives

Immune recovery among people living with HIV (PWHIV) receiving antiretroviral therapy (ART) is determined analysing CD4 cell counts and the CD4/CD8 ratio. Recovery to ≥ 800 CD4 cells/µl and CD4/CD8 ratio ≥ 1 was associated with favourable outcomes. We investigated immune recovery over 10 years among ART-naive PWHIV on ART.

Methods

Data were obtained from two German HIV cohorts, the HIV-1 Seroconverter study and the ClinSurv-HIV study, between 2003 and 2018. We included ART-naïve PWHIV starting with continuous ART and analysed CD4 cell counts and the CD4/CD8 ratio. The time to reaching immune thresholds was investigated using Kaplan–Meier analyses with inverse probability censoring weights.

Results

Overall, 8,927 participants were included. At baseline, PWHIV had a median CD4 cell count of 257 (interquartile range [IQR] 124–393) cells/µl and CD4/CD8 ratio of 0.26 (IQR 0.14–0.43). After ten years, median CD4 counts increased to 630 (IQR 474–811) cells/µl and CD4/CD8 ratio to 0.84 (IQR 0.61–1.11). PWHIV with higher baseline CD4 values and without viral failure had higher median CD4 counts and CD4/CD8 ratios. The cumulative probability of achieving a CD4 count ≥ 800 cells/µl and/or CD4/CD8 ratio ≥ 1 over 10 years of ART were 54% for the CD4 threshold, 53% for the CD4/CD8 ratio threshold, and 32% for both thresholds. CD4 at baseline was identified as a predictor to achieve immune recovery in all models.

Conclusions

Early diagnosis and treatment, as well as effective antiviral therapy without viral failure, should be considered to achieve long-term immune recovery among PWHIV.