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Medline ® Abstract for Reference 55

of 'Acute and early HIV infection: Treatment'

55
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Rapid CD4+ cell decrease after transient cART initiated during primary HIV infection (ANRS PRIMO and SEROCO cohorts).
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Seng R, Goujard C, Desquilbet L, Sinet M, Rouzioux C, Deveau C, Boufassa F, Delfraissy JF, Meyer L, Venet A, ANRS PRIMO and SEROCO Study Groups
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J Acquir Immune Defic Syndr. 2008;49(3):251.
 
OBJECTIVE: To modelize the rate of CD4 cell count decline and its determinants after cessation of combination antiretroviral therapy (cART) started during primary HIV infection (PHI) and compare it with never-treated patients.
METHODS: Kinetics of CD4 counts were analyzed on the square root scale by using a mixed-effects model in 170 patients who received cART during PHI from the Primary Infection (PRIMO) cohort and 123 never-treated patients from the Seroconverters (SEROCO) cohort.
RESULTS: After cART interruption in the PRIMO cohort, the CD4 cell count fell rapidly during the first 5 months and more slowly thereafter. The timing of treatment initiation had no influence on the rate of CD4 cell decline. In contrast, a larger increase in CD4 cell counts during cART was associated with a steeper decline and a larger loss of CD4 cells after treatment interruption. The mean CD4 cell loss 3 years postinterruption was 383 cells per microliter. In the SEROCO cohort, the CD4 T-cell decline was less steep (3-year CD4 loss 239 cells/microL). As a result, the mean CD4 cell counts were similar (416 cells/microL) 3 years after cART interruption (PRIMO) or after infection (SEROCO).
CONCLUSIONS: These data question the benefit of a limited course of cART even when initiated within 3 months after PHI diagnosis.
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INSERM U822, Le Kremlin-Bicêtre, France.
PMID