432. Clinical Outcome and Its Predictive Factors of Human Immunodeficiency Virus Infected Patients with Immunologic Failure despite Viral Suppression: Study from a Tertiary Referral Centre in Hong Kong
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
  • idsa-poster-432.pdf (311.7 kB)
  • Background: 

    Some of the individuals infected with human immunodeficiency virus (HIV) have unsatisfactory CD4+ T cell recovery despite satisfactory viral suppression after highly active antiretroviral therapy (HAART). This was termed immuno-virological discordance.


    Retrospective review was performed to study treatment-naiv naiv e HIV-infected patients with a baseline CD4+ cell count below 200cells/μL (n =168), under the care of the Queen Elizabeth Hospital from January 2003 to December 2008. Patients having satisfactory virological response (HIV-1 ribonucleic acid (RNA) below 50copies/mL) after 12 months of HAART were recruited. Immunological non-responders were defined as those having CD4+ cell count below 200cells/μL after 12 months of HAART. Complete responders are defined as those having CD4+ cell count increased to greater than or equal to 200cells/μL. Baseline characteristics and treatment outcomes were studied.


    Fifty-nine immunological non-responders and 109 complete responders were included in the analysis. Immunological non-responders were significantly older and had lower initial CD4+ cell count before HAART. They had higher risk of developing new AIDS-related events (P=0.001). Specifically during the initial 12 months of HAART, there were significantly more immunological non-responders had new AIDS events, mainly opportunistic infections (P<0.001). Immuno-virological discordance was identified as a risk factor (odds ratio 6.5, P=0.026) for AIDS events within the first 12 months of HAART. There was no significant difference in mortality between both groups.


    Immuno-virological discordance was a predictor for developing AIDS-related events. Expanded screening in at-risk groups should be promoted to detect HIV infections at earlier stages.

    Subject Category: H. HIV/AIDS and other retroviruses

    Tommy Hing-cheung Tang, MRCP (UK), Wilson Lam, MRCP (UK), Tak-chiu Wu, MRCP (UK), Man-po Lee, FRCP and Patrick Chung-ki Li, FRCP, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China


    T. H. C. Tang, None

    W. Lam, None

    T. C. Wu, None

    M. P. Lee, None

    P. C. K. Li, Abbott Laboratories: Scientific Advisor, Speaker honorarium
    Bristol Myers Squibb: No specific relationship; grant given to hospital, Travel grant to attend IAS Conference
    GSK: Scientific Advisor, Nil

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.