Elevated CD8 counts during HAART are associated with HIV virologic treatment failure

Elizabeth M. Krantz, Katherine Huppler Hullsiek, Jason F. Okulicz, Amy C. Weintrob, Brian K. Agan, Nancy F. Crum-Cianflone, Anuradha Ganesan, Tomas M. Ferguson, Braden R. Hale

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16 Scopus citations

Abstract

Objective: To evaluate whether elevated CD8 counts are associated with increased risk of virologic treatment failure in HIV-infected individuals. DESIGN:: Retrospective cohort study. Methods: US Military HIV Natural History Study participants who initiated highly active antiretroviral therapy (HAART) in 1996-2008 had 6-and 12-month post-HAART HIV RNA <400 copies per milliliter, 2 subsequent HIV viral loads and a baseline CD8 count were eligible (n = 817). Baseline was 12 months after the start of HAART, virologic failure (VF) was defined as confirmed HIV RNA 400 copies per milliliter, and CD8 counts 1200 cells per cubic millimeter were considered elevated. Cox models were used to examine the effect of baseline and time-updated CD8 counts on VF. RESULTS:: There were 216 failures for a rate of 5.6 per 100 person-years [95% confidence interval (CI): 4.9 to 6.4]. Among those initiating HAART in 2000-2008, the participants with elevated baseline CD8 counts had significantly greater risk of VF compared with those with baseline CD8 counts ≤600 cells per cubic millimeter [hazard ratio (HR) = 2.68, 95% CI: 1.13 to 6.35]. The participants with elevated CD8 counts at >20% of previous 6-month follow-up visits had a greater risk of failure at the current visit than those who did not (HR = 1.53, 95% CI: 1.14 to 2.06). Those with CD8 counts that increased after the start of HAART had a greater risk of failure than those with CD8 counts that decreased or remained the same (HR = 1.59, 95% CI: 1.19 to 2.13). Conclusions: Initial or serial elevated CD8 counts while on HAART or an increase in CD8 counts from HAART initiation may be early warnings for future treatment failure.

Original languageEnglish (US)
Pages (from-to)396-403
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume57
Issue number5
DOIs
StatePublished - Aug 15 2011

Keywords

  • CD8 count
  • HIV viral load suppression
  • HIV virologic failure
  • antiretroviral therapy
  • human immunodeficiency virus

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    Krantz, E. M., Hullsiek, K. H., Okulicz, J. F., Weintrob, A. C., Agan, B. K., Crum-Cianflone, N. F., Ganesan, A., Ferguson, T. M., & Hale, B. R. (2011). Elevated CD8 counts during HAART are associated with HIV virologic treatment failure. Journal of Acquired Immune Deficiency Syndromes, 57(5), 396-403. https://doi.org/10.1097/QAI.0b013e318221c62a