Analysis of the Influencing Factors of Immunological Nonresponders in Wuhan, China.

OBJECTIVE

CD4 cell recovery is hampered in some human immunodeficiency virus (HIV)-infected patients, despite a successful highly active antiretroviral therapy (HAART) with suppressed viral replication. We investigated the factors that might have hindered the CD4 cell recovery in these patients.

METHODS

In this retrospective study, we collected the data of all immune nonresponders (INRs) in Wuhan, China, until the end of 2020. A linear model was constructed based on the data from 220 patients with baseline and follow-up records. The response variables in this study were the CD4 cell count increase. The predictor variables considered in this study were those factors likely to affect the CD4 cell recovery.

RESULTS

Our findings revealed that the plasma HIV-1 viral load of all patients was suppressed and 87.3% patients' CD4 cells was increased after more than one year of the HAART treatment. In addition, their last follow-up showed a significant reduction in complications. In our results, the body mass index (BMI), number of months since HIV diagnosis to HAART start, and nonuse of co-trimoxazole were negatively correlated with the increase in CD4 cells ( < 0.05). However, there were positive associations between serum creatinine levels and CD4 cell recovery ( < 0.05). Further stratified analyses indicated that the associations between HAART replacement or creatinine usage and CD4 cell growth were only observed in those participants with a BMI <18.5 ( < 0.05).

CONCLUSIONS

An early initiation of HAART and co-trimoxazole preventive therapy (CPT) can promote immune reconstitution. BMI and serum creatinine can serve as monitoring indicators of immune reconstitution prognosis after the HAART.