@article{3107661,
    title = "Predictors of CD4 cell recovery following initiation of antiretroviral therapy among HIV-1 positive patients with well-estimated dates of seroconversion",
    author = "Stirrup, O.T. and Copas, A.J. and Phillips, A.N. and Gill, M.J. and Geskus, R.B. and Touloumi, G. and Young, J. and Bucher, H.C. and Babiker, A.G. and Kelleher, T. and Cooper, D. and Grey, P. and Finlayson, R. and Bloch, M. and Ramacciotti, T. and Gelgor, L. and Smith, D. and Zangerle, R. and Gill, J. and Lutsar, I. and Chêne, G. and Dabis, F. and Thiebaut, R. and Costagliola, D. and Guiguet, M. and Vanhems, P. and Chaix, M.-L. and Ghosn, J. and Meyer, L. and Boufassa, F. and Hamouda, O. and Meixenberger, K. and Bannert, N. and Bartmeyer, B. and Antoniadou, A. and Chrysos, G. and Daikos, G.L. and Pantazis, N. and Katsarou, O. and Rezza, G. and Dorrucci, M. and Monforte, A. and Luca, A. and Prins, M. and Geskus, R. and Helm, J. and Schuitemaker, H. and Sannes, M. and Brubakk, O. and Kran, A.-M. and Rosinska, M. and Muga, R. and Tor, J. and Olalla, P. and Cayla, J. and Moreno, S. and Monge, S. and Amo, J. and Romero, J. and Pérez-Hoyos, S. and Sönnerborg, A. and Bucher, C. and Günthard, H. and Scherrer, A. and Malyuta, R. and Murphy, G. and Porter, K. and Johnson, A. and Babiker, A. and Pillay, D. and Morrison, C. and Salata, R. and Mugerwa, R. and Chipato, T. and Price, M.A. and Gilmour, J. and Kamali, A. and Karita, E. and CASCADE Collaboration in EuroCoord",
    journal = "Neurobehavioral HIV Medicine",
    year = "2018",
    volume = "19",
    number = "3",
    pages = "184-194",
    publisher = "Wiley-Blackwell Publishing Ltd",
    doi = "10.1111/hiv.12567",
    keywords = "abacavir;  anti human immunodeficiency virus agent;  nonnucleoside reverse transcriptase inhibitor;  proteinase inhibitor;  ritonavir;  RNA directed DNA polymerase inhibitor;  tenofovir;  anti human immunodeficiency virus agent, adult;  antiretroviral therapy;  Article;  CD4 lymphocyte count;  female;  human;  Human immunodeficiency virus 1 infection;  major clinical study;  male;  prediction;  priority journal;  seroconversion;  virus load;  CD4 lymphocyte count;  clinical trial;  Human immunodeficiency virus 1;  Human immunodeficiency virus infection;  immunology;  multicenter study;  seroconversion;  statistical model;  treatment outcome, Anti-HIV Agents;  CD4 Lymphocyte Count;  Female;  HIV Infections;  HIV-1;  Humans;  Male;  Models, Statistical;  Seroconversion;  Treatment Outcome;  Viral Load",
    abstract = "Objectives: To investigate factors that predict speed of recovery and long-term CD4 cell count in HIV-1 seroconverters initiating combination antiretroviral therapy (cART), and to quantify the influence of very early treatment initiation. We make use of all pre-treatment CD4 counts, because analyses using only a single observation at initiation may be subject to biases. Methods: We used data from the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) multinational cohort collaboration of HIV-1 seroconverters. We analysed pre- and post-treatment data of patients with seroconversion dates estimated January 2003–March 2014 (n = 7600 for primary analysis) using a statistical model in which the characteristics of recovery in CD4 counts are determined by multiple predictive factors. Secondary analyses were performed incorporating uncertainty in the exact timing of seroconversion to allow more precise estimation of the benefit of very early treatment initiation. Results: ‘True’ CD4 count at cART initiation was the strongest predictor of CD4 count beyond 3 years on cART. Allowing for lack of complete certainty in the date of seroconversion, CD4 recovery was more rapid for patients in whom treatment was initiated within 4 months. For a given CD4 count, higher viral load (VL) at initiation was strongly associated with higher post-treatment CD4 recovery. For other patient and drug characteristics, associations with recovery were statistically significant but small in magnitude. Conclusions: CD4 count at cART initiation is the most important factor in predicting post-treatment recovery, but VL provides substantial additional information. If cART is initiated in the first 4 months following seroconversion, recovery of CD4 counts appears to be more rapid. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association"
}