O'Connor Jemma L, Smith Colette J, Lampe Fiona C, Hill Teresa, Gompels Mark, Hay Phillip, Chadwick David, Fisher Martin, Ainsworth Jonathan, Gilson Richard, Mackie Nicky, Anderson Jane, Orkin Chloe, Nelson Mark, Kegg Stephen, Leen Clifford, Palfreeman Adrian, Post Frank, Johnson Margaret, Sabin Caroline A, Phillips Andrew N
aResearch Department of Infection & Population Health, UCL, London bNorth Bristol NHS Trust, Bristol cSt. George's Healthcare NHS Trust, London dSouth Tees Hospitals NHS Foundation Trust, Middlesbrough eBrighton and Sussex University Hospitals NHS Trust, Brighton fNorth Middlesex University Hospital NHS Trust gMortimer Market Centre, University College Medical School hImperial College Healthcare NHS Trust iHomerton University Hospital NHS Trust jBarts and The London NHS Trust kChelsea and Westminster Hospital NHS Foundation Trust lSouth London Healthcare NHS Trust, London mThe Lothian University Hospitals NHS Trust, Edinburgh nUniversity Hospitals of Leicester NHS Trust, Leicester oKings College Hospital NHS Foundation Trust, London, UK pRoyal Free Hampstead NHS Trust, London, UK.
AIDS. 2014 Mar 27;28(6):919-24. doi: 10.1097/QAD.0000000000000165.
To assess CD4 cell count recovery in people severely immunosuppressed at start of antiretroviral therapy (ART) who achieve and maintain viral load suppression.
Eligible participants from the UK Collaborative HIV Cohort Study started ART with at least three drugs after 1 January 2000. Participants were required to have pre-ART CD4 cell count below 100 cells/μl, at least 2 years of follow-up on ART, have achieved viral load suppression (≤ 50 copies/ml) by 9 months after starting ART and to have maintained this throughout follow-up. Participants were further required to be regularly engaged with care. We calculated the proportion of people who failed to achieve a CD4 cell count of more than 100, 150, 200, 350 and 500 cells/μl by the time of the last follow-up, or 5 years from start of ART, whichever occurred first (censoring date).
Of the 400 participants [median (interquartile range) pre-ART CD4 cell count of 38 (14-65) cells/μl], 2 (0.5%), 8 (2%), 28 (7%), 131 (33%) and 259 (65%) failed to achieve a CD4 cell count of more than 100, 150, 200, 350 and 500 cells/μl, by the censoring date, respectively. Kaplan-Meier estimates of the proportion of people reaching each CD4 cell count threshold after 1 year on ART were 88, 70, 50, 14 and 3%, respectively, and after 3 years on ART, 98, 95, 90, 59 and 25%, respectively. Median (interquartile range) follow-up on ART was 3.9 (2.7-4.8) years.
Given a person with pre-ART CD4 cell count below 100 cells/μl survives and maintains consistent viral load suppression on ART, there is over a 90% chance of reaching a CD4 cell count above 200 cells/μl by 3 years.
评估在开始抗逆转录病毒治疗（ART）时严重免疫抑制且实现并维持病毒载量抑制的人群中CD4细胞计数的恢复情况。
来自英国HIV协作队列研究的符合条件的参与者于2000年1月1日后开始接受至少三种药物的ART治疗。参与者要求ART治疗前CD4细胞计数低于100个/μl，接受ART治疗至少随访2年，在开始ART治疗9个月后实现病毒载量抑制（≤50拷贝/ml）并在整个随访期间维持这一水平。参与者还需定期接受治疗。我们计算了在最后一次随访时或从ART治疗开始5年（以先到者为准，即截尾日期）时未达到CD4细胞计数超过100、150、200、350和500个/μl的人群比例。
400名参与者（ART治疗前CD4细胞计数中位数[四分位间距]为38[14 - 65]个/μl）中，分别有2名（0.5%）、8名（2%）、28名（7%）、131名（33%）和259名（65%）在截尾日期时未达到CD4细胞计数超过100、150、200、350和500个/μl。ART治疗1年后达到各CD4细胞计数阈值的人群比例的Kaplan-Meier估计值分别为88%、70%、50%、14%和3%，ART治疗3年后分别为98%、95%、90%、59%和25%。ART治疗的中位（四分位间距）随访时间为3.9（2.7 - 4.8）年。
对于ART治疗前CD4细胞计数低于100个/μl且存活并在ART治疗中维持一致病毒载量抑制的人，3年内CD4细胞计数超过2
