dc.contributor.author | Hunt, Peter W. | |
dc.contributor.author | Cao, Huyen L. | |
dc.contributor.author | Muzoora, Conrad | |
dc.contributor.author | Ssewanyana, Isaac | |
dc.contributor.author | Bennett, John | |
dc.contributor.author | Emenyonu, Nneka | |
dc.contributor.author | Kembabazi, Annet | |
dc.contributor.author | Neilands, Torsten B. | |
dc.contributor.author | Bangsberg, David R. | |
dc.contributor.author | Deeks, Steven G. | |
dc.contributor.author | Martin, Jeffrey N. | |
dc.date.accessioned | 2022-02-07T07:49:28Z | |
dc.date.available | 2022-02-07T07:49:28Z | |
dc.date.issued | 2011 | |
dc.identifier.citation | Hunt, P. W., Cao, H. L., Muzoora, C., Ssewanyana, I., Bennett, J., Emenyonu, N., ... & Martin, J. N. (2011). Impact of CD8+ T cell activation on CD4+ T cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapy. AIDS (London, England), 25(17), 2123. | en_US |
dc.identifier.issn | 2123–2131 | |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1393 | |
dc.description.abstract | Objectives—To assess whether T cell activation independently predicts the extent of CD4+ T
cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapy (ART).
Design—Prospective cohort study
Methods—HIV-infected adults starting ART and achieving a plasma HIV RNA level (VL) <400
copies/ml by month 6 were sampled from the Uganda AIDS Rural Treatment Outcomes (UARTO)
cohort in Mbarara, Uganda. CD4 count, VL, and the % activated (CD38+HLA-DR+) T cells were
measured every 3 months.
Results—Of 451 HIV-infected Ugandans starting ART, most were women (70%) with median
pre-ART values: age, 34 years; CD4 count, 135 cells/mm3; and VL, 5.1 log10 copies/ml. Of these,
93% achieved a VL<400 c/ml by month 6 and were followed for a median of 24 months, with 8%
lost to follow up at 3 years. Higher pre-ART CD8+ T cell activation was associated with
diminished CD4 recovery after year 1, after adjustment for pre-ART CD4 count, VL, and gender
(P=0.017). Thirty-four participants died, 15 after month 6. Each 10 percentage-point increase in
activated CD8+ T cells at month 6 of suppressive ART was associated with a 1.6-fold increased
hazard of subsequent death after adjusting for pre-therapy CD4 count (P=0.048).
Conclusions—Higher pre-ART CD8+ T cell activation independently predicts slower CD4+ T
cell recovery and higher persistent CD8+ T cell activation during ART-mediated viral suppression
independently predicts increased mortality among HIV-infected Ugandans. Novel therapeutic
strategies aimed at preventing or reversing immune activation during ART are needed in this
setting. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | AIDS | en_US |
dc.subject | HIV | en_US |
dc.subject | Uganda | en_US |
dc.subject | Sub-Saharan Africa | en_US |
dc.subject | T cell activation | en_US |
dc.subject | Antiretroviral Therapy | en_US |
dc.subject | Mortality | en_US |
dc.title | Impact of CD8+ T Cell Activation on CD4+ T Cell Recovery and Mortality in HIV-infected Ugandans Initiating Antiretroviral Therapy | en_US |
dc.type | Article | en_US |