Virological effectiveness and CD4+ T-cell increase over early and late courses in HIV infected patients on antiretroviral therapy focus on HCV and anchor class received 英文参考文献.docVIP

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Virological effectiveness and CD4+ T-cell increase over early and late courses in HIV infected patients on antiretroviral therapy focus on HCV and anchor class received 英文参考文献.doc

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VirologicaleffectivenessandCD4T-cellincreaseoverearlyandlatecoursesinHIVinfectedpatientsonantiretroviraltherapyfocusonHCVandanchorclassreceived英文参考文献

Mottaetal.AIDSResearchandTherapy2012,9:18 /content/9/1/18 RESEARCH OpenAccess VirologicaleffectivenessandCD4+T-cellincrease overearlyandlatecoursesinHIVinfected patientsonantiretroviraltherapy:focusonHCV andanchorclassreceived DavideMotta1,NigritellaBrianese1,EmanueleFocà1*,PaolaNasta8,FrancoMaggiolo2,MassimilianoFabbiani3, GiulianaCologni2,SimonaDiGiambenedetto3,MassimoDiPietro4,NicolettaLadisa5,LauraSighinolfi6, SilviaCostarelli7,FilippoCastelnuovo8andCarloTorti1,9 Abstract Background:TheaimofthisstudywastoexploretheeffectsofHCVco-infectiononvirologicaleffectivenessand onCD4+T-cellrecoveryinpatientswithanearlyandsustainedvirologicalresponseafterHAART. Methods:Weperformedalongitudinalanalysisof3,262patientsfromtheMASTERcohort,whostartedHAART from2000to2008.Patientswerestratifiedinto6groupsbyHCVstatusandtypeofanchorclass.Theearly virologicaloutcomewastheachievementofHIVRNA500copies/ml4–8monthsafterHAARTinitiation.Timeto virologicalresponsewasalsoevaluatedbyKaplan-Meieranalysis.Themainoutcomemeasureofearly immunologicalresponsewastheachievementofCD4+T-cellincreaseby≥100/mm3frombaselinetomonth4–8 invirologicalresponderpatients.LateimmunologicaloutcomewasabsolutevariationofCD4+T-cellcountwith respecttobaselineuptomonth24.Multivariableanalysis(ANCOVA)investigatedpredictorsforthisoutcome. Results:TheearlyvirologicalresponsewashigherinHCVAb-negativethanHCVAb-positivepatientsprescribedPI/r (92.2%versus88%;p=0.01)orNNRTI(88.5%versus84.7%;p=0.06).HCVAb-positiveserostatuswasasignificantpredictor ofadelayedvirologicalsuppressionindependentlyfromothervariables,includingtypesofanchorclass.Reactivityfor HCVantibodieswasassociatedwithalowerprobabilityofobtaining≥100/mm3CD4+increasewithin8monthsfrom HAARTinitiationinpatientstreatedwithPI/r(62.2%amongHCVAb-positivepatientsversus70.9%amongHCVAb- negativepatients;p=0.003)andNNRTI(63.7%versus74.7%;p0.001).RegardinglateCD4+increase,positiveHCVAb appearedtoimpairimmunereconstitutionintermsofabsoluteCD4+T-cellcountincreasebothinpatients