Predictors of CD4 count change over 8 months of follow up in HIV-1-infected patients with a CD4 count ≥ 300 cells/μL who were assigned to 7.5 MIU interleukin-2

Zoe Fox, Francisco Antunes, Rick Davey, Brian Gazzard, Nancy Klimas, Ann Labriola, Marcelo Losso, James D. Neaton, Andrew Phillips, Kiat Ruxrungtham, Schlomo Staszewski, Laurence Weiss, D. Jens Lundgren, Liliana Aguilar, Eleonora Betina Angel, Silvia Aquilia, Waldo Belloso, Jorge Benetucci, Victor Bittar, Pedro CahnArnaldo Casiro, Jorge Contarelli, Jorge Corral, Lucia Daciuk, Daniel David, Ines Ferrari, Diego Fridman, Viviana Galache, Graciela Guaragna, Silvina Ivalo, Hector Laplume, Isabel Lanusse, Maria B. Lasala, Roberta Lattes, Jaime Lasovsky, Gustavo Lopardo, Marcelo Losso, Leonardo Lourtau, Sergio Lupo, Aldo Maranzana, Cristina Marson, Lucila Massera, Marisa del Lujan Sanchez, Carla Somenzini, Mariel Tocci, Sally Algar, Jonathan Anderson, David Baker, Kathy Blavius, Mark Bloch, Michael Boyle, David Bradford, Phillip Britton, Leah Carrall, Andrew Carr, John Chuah, Michael Curry, Clive D'Arcy-Evans, Pauline Dobson, Nicholas Doong, Cari Egan, Wendy Ferguson, Robert Finlayson, Martyn French, Anthony Frater, Julian Gold, Philip Habel, Kay Haig, Rohan Holland, Natalie Hyland, Jennifer Hoy, Jeff Hudson, Robyn James, Jenny Leung, Kaye Lowe, Karen MacRae, Marilyn McMurchie, Nicholas Medland, Samantha Miller, Jo Murray, Rosie Newman, Orth David, Julie Patching, Ruth Primrose, Hugo Ree, Robyn Richardson, Gary Rogers, Janine Roney, Norman Roth, Jeganathan Sarangapany, David Shaw, Carol Silberberg, Alan Skett, Robyn Vale, Claudio Villella, Alan Walker, Ashley Watson, Ngaire Wendt, Helen Wood

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: ESPRIT is a randomized trial comparing the clinical impact of interleukin (IL)-2 plus antiretrovirals vs antiretrovirals alone. Identification of factors that influence the relationship between IL-2 and CD4 count recovery will enable better personalization of treatment with IL-2 in HIV-1-positive individuals. The IL-2 induction phase consists of three dosing cycles over 6-8 months (7.5 MIU twice a day, for 5 days every 8 weeks). Methods: We included patients initiating IL-2 at the 7.5 MIU dose with an 8-month CD4 count, measured at least 30 days after their last cycle. We identified baseline predictors of CD4 count changes over 8 months using linear regression. Results: Of 2090 patients assigned IL-2, 1673 (80%) were included in the analysis. The median (interquartile range) baseline CD4 count was 461 (370, 587) cells/μL with a median increase of 233 (90, 411) cells/μL at month 8. After adjustments, significant predictors of CD4 count change included CD4 nadir (29.8 cells/μL greater increase per 100 cells/μL higher; P < 0.0001), last CD4 count before baseline (mean 36.0 cells/μL greater increase per 100 cells/μL higher; P < 0.0001), time from antiretroviral start to baseline (8.3 cells/μL smaller increase per year longer; P = 0.001), age (11.7 cells/μL smaller increase per 5 years older; P = 0.005) and race (79.7 cells/μL greater increase for black patients vs white patients; P = 0.003). A linear relationship existed between total IL-2 dose in the first cycle and CD4 count change (73.1 cells/μL greater increase per 15 MIU higher; P < 0.0001). Conclusions: Prior nadir and current CD4 counts, age and IL-2 dose are major determinants of CD4 increases induced by with intermittent administration of IL-2 in HIV-1-positive individuals on antiretrovirals. The clinical function of these induced CD4 cells is under study.

Original languageEnglish (US)
Pages (from-to)112-123
Number of pages12
JournalHIV Medicine
Volume8
Issue number2
DOIs
StatePublished - Mar 2007

Keywords

  • 7.5 MIU proleukin
  • CD4 cell count responses
  • Subcutaneous recombinant interleukin-2

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