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
Handouts
  • 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.

    Methods: 

    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.

    Results: 

    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.

    Conclusion: 

    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

    Disclosures:

    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.