Impact of CD8R T-cell activation on CD4R T-cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapy

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dc.contributor.authorHunt, Peter W.
dc.contributor.authorCaoa, Huyen L.
dc.contributor.authorMuzoora, Conrad
dc.contributor.authorSsewanyana, Isaac
dc.contributor.authorBennett, John
dc.contributor.authorEmenyonu, Nneka
dc.contributor.authorKembabazi, Annet
dc.contributor.authorNeilands, Torsten B.
dc.contributor.authorBangsberg, David R.
dc.contributor.authorDeeks, Steven G.
dc.contributor.authorMartin, Jeffrey N.
dc.date.accessioned2022-01-31T13:01:25Z
dc.date.available2022-01-31T13:01:25Z
dc.date.issued2011
dc.description.abstractTo assess whether T-cell activation independently predicts the extent of CD4þ T-cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapy (ART). Prospective cohort study. HIV-infected adults starting ART and achieving a plasma HIV RNA level (VL) less than 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 percentage-activated (CD38þHLA-DRþ) T cells were measured every 3 months. Of 451 HIV-infected Ugandans starting ART, most were women (70%) with median pre-ART values: age, 34 years; CD4 count, 135 cells/ml; and VL, 5.1 log10 copies/ml. Of these, 93% achieved a VL less than 400 copies/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 CD8þ T-cell activation was associated with diminished CD4 recovery after year 1, after adjustment for pre-ART CD4 count, VL, and sex (P¼0.017). Thirty-four participants died, 15 after month 6. Each 10% point increase in activated CD8þ T cells at month 6 of suppressive ART was associated with a 1.6-fold increased hazard of subsequent death after adjusting for pretherapy CD4 count (P¼0.048). Higher pre-ART CD8þ T-cell activation independently predicts slower CD4þ T-cell recovery and higher persistent CD8þ 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.identifier.citationHunt, 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. DOI:10.1097/QAD.0b013e32834c4ac1en_US
dc.identifier.other10.1097/QAD.0b013e32834c4ac1
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1675
dc.language.isoenen_US
dc.publisherAIDS (London, England)en_US
dc.subjectAntiretroviral therapyen_US
dc.subjectHIVen_US
dc.subjectMortalityen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectT-cell activationen_US
dc.subjectUgandaen_US
dc.titleImpact of CD8R T-cell activation on CD4R T-cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapyen_US
dc.typeArticleen_US
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