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Incidence of AIDS-defining illness decreased with higher CD4 counts
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For patients with CD4 cell counts of more than 200 cells/mm3, the incidence of AIDS-defining illnesses decreased with higher counts, according to researchers with the opportunistic infections working group of the COHERE study.
The incidence of AIDS-defining illnesses did not continue to decrease with CD4 cell counts of 1,000 cells/mm3 or more, they reported in Clinical Infectious Diseases.
“There is preliminary evidence that the risk of AIDS-defining illnesses continues to decrease as CD4 count increases, even at CD4 counts of >500 cells/mm3, but, to our knowledge, there are few studies that have specifically considered the incidence of individual AIDS-defining illnesses at higher CD4 counts,” the researchers wrote.
The researchers analyzed data from the COHERE collaboration of 33 cohorts of patients with HIV throughout Europe. The analysis included data on 207,539 patients collected from 1998 to 2010 on patient demographics, ART use, CD4 cell counts, AIDS-defining illnesses and death. All of the patients in the analysis had CD4 cell counts of 200 cells/mm3 or more.
There were 12,135 AIDS-defining illnesses identified among the patients. Among those with CD4 counts of 200 cells/mm3 to 349 cells/mm3, the incidence of AIDS-defining illnesses was 20.5 per 1,000 person-years of follow-up. Among patients with CD4 cell counts of 1,000 cells/mm3 or more, the incidence of AIDS-defining illnesses was 4.1 per 1,000 person-years of follow-up.
The incidence of AIDS-defining illnesses declined with higher cell counts. For those with counts of 500 cells/mm3 to 749 cells/mm3, the incidence was 6.4 per 1,000 person-years of follow-up (vs. 20.5 for those with counts of 200 cells/mm3 to 349 cells/mm3). It was even lower among patients with cell counts of 750 cells/mm3 to 999 cells/mm3 — 4.7 per 1,000 person-years of follow-up. There was no difference in AIDS-defining illnesses between patients with cell counts of 750 cells/mm3 to 999 cells/mm3 and those with cell counts of 1,000 cells/mm3 or more.
“Knowledge of the risk of a specific AIDS-defining illness at a given CD4 lymphocyte count and the identification of a possible threshold of immunodeficiency have important implications for patient management, as well as providing an important reference for the incidence of a wide range of AIDS-defining illnesses at higher CD4 counts,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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