TITLE

HIV Infection, Antiretroviral Therapy, and CD4+ Cell Count Distributions in African Populations

AUTHOR(S)
Williams, Brian G.; Korenromp, Eline L.; Gouws, Eleanor; Schmid, George P.; Auvert, Bertran; Dye, Christopher
PUB. DATE
November 2006
SOURCE
Journal of Infectious Diseases;11/15/2006, Vol. 194 Issue 10, p1450
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background. The variability in CD4+ cell counts within and among human immunodeficiency virus (HIV)-positive and -negative African populations has not been explained but has important implications for understanding the incidence of HIV-related opportunistic infections, especially tuberculosis, in both individuals and populations. Methods. In HIV-negative African adults, CD4+ cell counts vary within populations (interquartile ranges [IQRs], 169–603 cells/mL) and among populations (means vary from 699 to 1244 cells/mL), with similarly wide variations in HIV-positive adults. We developed dynamic mathematical models to predict the distribution of CD4+ cell counts in HIV-positive adults using the distribution in HIV-negative adults. Results. Under the assumption that survival is independent of the CD4+ cell count before seroconversion, we fitted the observed distributions in HIV-positive adults. At a CD4+ cell count of 200 cells/mL, the median life expectancy of HIV-positive Zambians (4.0 years) was predicted to be 1.7 times that of HIV-positive South Africans (2.3 years). Conclusions. The model provides a way to estimate the changing distribution of CD4+ cell counts and, hence, the changing incidence of HIV-related opportunistic infections as the epidemic matures. This could substantially improve the planning of health services, including the need and demand for antiretroviral therapy. Better data are needed to test the model and its assumptions more rigorously and to fully understand the variability in CD4+ cell counts within and among populations.
ACCESSION #
22850074

 

Related Articles

  • Co-Infection with Opportunistic Pathogens Promotes Human Immunodeficiency Virus Type 1 Infection... Wahl, Sharon M.; Greenwell-Wild, Teresa; Gang Peng; Hale-Donze, Hollie; Orenstein, Jan M. // Journal of Infectious Diseases;5/15/99 Supplement 3, Vol. 179, pS457 

    Demonstrates the reciprocal relationship between opportunistic infections (OI) and HIV type 1 on macrophages. Dependence of HIV-1 on susceptible host cells that express both CD4 and chemokine co-receptors; Possibility of HIV replication in infected lymphocytes and macrophages; Enhancement of...

  • Early and Long-Lasting Alteration of Effector CD45RA−Foxp3high Regulatory T-Cell Homeostasis During HIV Infection. Simonetta, Federico; Lecuroux, Camille; Girault, Isabelle; Goujard, Cécile; Sinet, Martine; Lambotte, Olivier; Venet, Alain; Bourgeois, Christine // Journal of Infectious Diseases;May2012, Vol. 205 Issue 10, p1510 

    Regulatory T-cell (Treg) quantification in human immunodeficiency virus (HIV) infection remains ill defined because of the lack of reliable specific markers to identify human Tregs and the diversity of clinical stages of HIV infection. Using a recently described Treg identification strategy...

  • CD4+ T cell-independent DNA vaccination against opportunistic infections. Mingquan Zheng; Ramsay, Alistair J.; Robichaux, Myles B.; Norris, Karen A.; Kliment, Corrine; Crowe, Christopher; Rapaka, Rekha R.; Steele, Chad; McAllister, Florencia; Shellito, Judd E.; Marrero, Luis; Schwarzenberger, Paul; Qiu Zhong; Kolls, Jay K. // Journal of Clinical Investigation;Dec2005, Vol. 115 Issue 12, p3536 

    Depletion or dysfunction of CD4+ T lymphocytes profoundly perturbs host defenses and impairs immunogenicity of vaccines. Here, we show that plasmid DNA vaccination with a cassette encoding antigen (OVA) and a second cassette encoding full-length CD40 ligand (CD40L), a molecule expressed on...

  • Effect of combination antiretroviral therapy on CD4 T cell count.  // Clinical Infectious Diseases;10/15/2008, Vol. 47 Issue 8, pi 

    The article discusses the study on the effect of combination of antiretroviral therapy on CD4 T cell count published within the issue.

  • The Impact of HIV Infection and CD4 Cell Count on the Performance of an Interferon Gamma Release Assay in Patients with Pulmonary Tuberculosis. Aabye, Martine G.; Ravn, Pernille; PrayGod, George; Jeremiah, Kidola; Mugomela, Apolinary; Jepsen, Maria; Faurholt, Daniel; Range, Nyagosya; Friis, Henrik; Changalucha, John; Andersen, Aase B. // PLoS ONE;2009, Vol. 4 Issue 1, p1 

    Background: The performance of the tuberculosis specific Interferon Gamma Release Assays (IGRAs) has not been sufficiently documented in tuberculosis- and HIV-endemic settings. This study evaluated the sensitivity of the QuantiFERON TB-Gold In-Tube (QFT-IT) in patients with culture confirmed...

  • ART imitates life: the puzzle of HIV, ageing and antiretroviral treatment. Hoy, Jennifer; Vujovic, Olga // HIV Australia;2009, Vol. 8 Issue 3, p20 

    The article discusses the treatment of HIV and age-related HIV infection with the use of antiretroviral therapy. It refers to a SMART study which found out that it does not only prevent HIV-related opportunistic infection but also in non-AIDS complications including heart disease, cancer, and...

  • Multiple opportunistic infections in an unusual patient with human immunodeficiency virus infection. Garg, Ravindra Kumar; Paliwal, Vimal; Sharma, Rohitash; Desai, Parthiv; Kar, Alok Mohan // Annals of Indian Academy of Neurology;Apr2007, Vol. 10 Issue 2, p109 

    A marked decrease in incidence has been observed for most central nervous system opportunistic infections after the use of highly active antiretroviral therapy. In developing countries, where highly active antiretroviral therapy is still unavailable, unusual patients are encountered. We are...

  • Opportunistic Infection Prophylaxis Can Be Safely Dropped After CD4 Recovery.  // Guide;Jan2003, Vol. 23 Issue 1, p39 

    Reports on the findings of a research on the suspension of opportunistic infection prophylaxis after antiretroviral treatment in HIV patients. CD4 cell counts after prophylaxis suspension; Occurrence of relapses.

  • HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. Deeks, Steven G.; Phillips, Andrew N. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;1/31/2009, p288 

    The article discusses HIV infection, treatment with antiretroviral drugs, aging, and morbidity from non-AIDS related conditions such as hypertension, diabetes, dementia, and kidney failure. Topics include the association of lower CD4+ T cell counts with the risk of cancer and liver disease, the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics