Trend of CD4+ cell counts at diagnosis and initiation of highly active antiretroviral therapy (HAART)

Korea HIV/AIDS cohort study, 1992-2015

Korea HIV/AIDS Cohort Study

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. Materials and Methods: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and > 500 cells/mm3). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001- 200,000, 200,001-1,000,000, and > 1,000,000 copies/mL. Results: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm3 and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm3 and 83,500 copies/ mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm3) at diagnosis (31-51%) and initiation of HAART accounted for the largest proportion (30-65%) over the three-year time intervals. This proportion increased until 2010-2012. Conclusion: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.

Original languageEnglish
Pages (from-to)101-108
Number of pages8
JournalInfection and Chemotherapy
Volume49
Issue number2
DOIs
Publication statusPublished - 2017 Jun 1

Fingerprint

Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Korea
Acquired Immunodeficiency Syndrome
Cohort Studies
HIV
RNA
Viral Load
Republic of Korea
Virus Diseases
Tertiary Care Centers
Cell Count
Guidelines

Keywords

  • CD4+ Lymphocyte Count
  • Cohort Study
  • Human immunodeficiency virus

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Trend of CD4+ cell counts at diagnosis and initiation of highly active antiretroviral therapy (HAART) : Korea HIV/AIDS cohort study, 1992-2015. / Korea HIV/AIDS Cohort Study.

In: Infection and Chemotherapy, Vol. 49, No. 2, 01.06.2017, p. 101-108.

Research output: Contribution to journalArticle

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abstract = "Background: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. Materials and Methods: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and > 500 cells/mm3). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001- 200,000, 200,001-1,000,000, and > 1,000,000 copies/mL. Results: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm3 and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm3 and 83,500 copies/ mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm3) at diagnosis (31-51{\%}) and initiation of HAART accounted for the largest proportion (30-65{\%}) over the three-year time intervals. This proportion increased until 2010-2012. Conclusion: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.",
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author = "{Korea HIV/AIDS Cohort Study} and Kim, {Min Jung} and Chang, {Hyun Ha} and Kim, {Sang Il} and Kim, {Youn Jeong} and Park, {Dae Won} and Chun Kang and Kee, {Mee Kyung} and Choi, {Ju yeon} and Kim, {Soo Min} and Choi, {Bo Youl} and Kim, {Woo Joo} and Kim, {June Myung} and Choi, {Jun Yong} and Choi, {Young Hwa} and Lee, {Jin Soo} and Kim, {Shin Woo} and Min, {Ja Kim} and Sohn, {Jang Wook} and Yoon, {Young Kyung} and Woo, {Jun Hee} and Kim, {Youn Jeong} and Wonseok Choi and Wie, {Seong Heon} and Hur, {Ji An} and Kim, {Min Jung} and Lee, {Sang Ah} and Joon-Young Song and Eom, {Joong Shik} and Lee, {Jin Seo} and Park, {So Yeon} and Jeong, {Hye Won} and Lee, {Jin Soo} and Baek, {Ji Hyeon} and Choi, {Hee Jung} and Choi, {Jun Yong} and Ku, {Nam Su} and Kim, {Hyo Youl} and Choi, {Young Hwa} and Lee, {Eun Jung} and Kim, {Tae Hyong} and Choi, {Bo Youl} and Choi, {Ju Yeon}",
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T1 - Trend of CD4+ cell counts at diagnosis and initiation of highly active antiretroviral therapy (HAART)

T2 - Korea HIV/AIDS cohort study, 1992-2015

AU - Korea HIV/AIDS Cohort Study

AU - Kim, Min Jung

AU - Chang, Hyun Ha

AU - Kim, Sang Il

AU - Kim, Youn Jeong

AU - Park, Dae Won

AU - Kang, Chun

AU - Kee, Mee Kyung

AU - Choi, Ju yeon

AU - Kim, Soo Min

AU - Choi, Bo Youl

AU - Kim, Woo Joo

AU - Kim, June Myung

AU - Choi, Jun Yong

AU - Choi, Young Hwa

AU - Lee, Jin Soo

AU - Kim, Shin Woo

AU - Min, Ja Kim

AU - Sohn, Jang Wook

AU - Yoon, Young Kyung

AU - Woo, Jun Hee

AU - Kim, Youn Jeong

AU - Choi, Wonseok

AU - Wie, Seong Heon

AU - Hur, Ji An

AU - Kim, Min Jung

AU - Lee, Sang Ah

AU - Song, Joon-Young

AU - Eom, Joong Shik

AU - Lee, Jin Seo

AU - Park, So Yeon

AU - Jeong, Hye Won

AU - Lee, Jin Soo

AU - Baek, Ji Hyeon

AU - Choi, Hee Jung

AU - Choi, Jun Yong

AU - Ku, Nam Su

AU - Kim, Hyo Youl

AU - Choi, Young Hwa

AU - Lee, Eun Jung

AU - Kim, Tae Hyong

AU - Choi, Bo Youl

AU - Choi, Ju Yeon

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. Materials and Methods: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and > 500 cells/mm3). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001- 200,000, 200,001-1,000,000, and > 1,000,000 copies/mL. Results: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm3 and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm3 and 83,500 copies/ mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm3) at diagnosis (31-51%) and initiation of HAART accounted for the largest proportion (30-65%) over the three-year time intervals. This proportion increased until 2010-2012. Conclusion: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.

AB - Background: CD4+ cell counts reflect immunologic status of human immunodeficiency virus (HIV) patients. Recommended CD4+ cell counts for the initiation of highly active antiretroviral therapy (HAART) has increased over the past several years in various HIV treatment guidelines. We investigated the trend of CD4+ cell counts at diagnosis and treatment start using data from the Korea HIV/acquired immune deficiency syndrome (AIDS) Cohort Study. Materials and Methods: The Korea HIV/AIDS Cohort Study started in 2006 and enrolled HIV patients from 21 tertiary and secondary hospitals in South Korea. The data for CD4+ cell counts at diagnosis and HAART initiation from these HIV patients were analyzed by three-year time intervals and presented by number of CD4+ cells (≤100, 101-200, 201-350, 351-500 and > 500 cells/mm3). The HIV-RNA titer at diagnosis and HAART initiation were presented by 3-year intervals by groups ≤50,000, 50,001-100,000, 100,001- 200,000, 200,001-1,000,000, and > 1,000,000 copies/mL. Results: Median values of CD4+ cell count and HIV-RNA titer at initial HIV diagnosis were 247 cells/mm3 and 394,955 copies/mL, respectively. At time of initiating HAART, median values of CD4+ cell count and HIV-RNA were 181 cells/mm3 and 83,500 copies/ mL, respectively. Patients with low CD4+ cell count (CD4+ cell count ≤200 cells/mm3) at diagnosis (31-51%) and initiation of HAART accounted for the largest proportion (30-65%) over the three-year time intervals. This proportion increased until 2010-2012. Conclusion: CD4+ cell count at initiation of HAART was found to be very low, and the increase in late initiation of HAART in recent years is of concern. We think that this increase is primarily due to an increasing proportion of late presenters. We recommend early detection of HIV patients and earlier start of HAART in order to treat and prevent spread of HIV infection.

KW - CD4+ Lymphocyte Count

KW - Cohort Study

KW - Human immunodeficiency virus

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