Impact of baseline CD4 count, immune recovery and viral suppression at 1 year of first highly active antiretroviral therapy on survival, AIDS defining events and immune recovery reactions Impacto de la inmunodepresión basal y su grado de recuperación al a

Abstract

Background: Baseline (BL) CD4 cell count is a major factor in outcome of highly active antiretroviral therapy (HAART); treatment induced immune recovery and viral response can modulate this outcome. Aim: To evaluate the association between baseline CD4 cell count and outcome during the first HAART regimen. Material and methods: Prospective study in 2,050 patients on first HAART with a follow up (f/u) of at least 1 year. All had BL CD4 and viral load (VL) counts which were repeated at least twice a year. Patients were grouped according to BL CD4 (cells/mm 3) in <100 (G1), 100-199 (G2) and ≥200 (G3). Groups were further divided according to immune and virological response at 1 year in CD4 > or < 200 and VL detectable or undetectable (<80 copies/mL). Outcome measures were death, AIDS defining events (ADE) and, as a surrogate marker of immune recovery reaction, herpes zoster (HZ). Results: During the first year of follow up, 113 patients (10.8%) died in G1 (n =1,044), 17 (2.5%) in G2 (n =6