1067 
CD4 T Lymphocyte Recovery with ART Is Not Directly Influenced by HCV-co-Infection Status
Curtis Cooper*1, B Hutton1, E Mills2, and J Angel1
1Univ of Ottawa and Ottawa Hlth Res Inst, Canada and 2BC Ctr for Excellence in HIV/AIDS, Vancouver, Canada
Background: It is unclear whether CD4 count recovery
following combination ART (cART) initiation is blunted in HIV/hepatitis C virus
(HCV) -co-infected patients compared to HIV-mono-infected patients. If so, it
is unknown whether this is a direct consequence of HCV infection or a result of
concurrent socioeconomic factors including substance abuse.
Methods: First-time recipients of cART from January 1996
to August 2007 were identified using The Ottawa Hospital Immunodeficiency
Database (SPSS 14.0). Change from baseline in CD4 count at months 3, 6, 9, and
12 was assessed as a function of HCV status, baseline CD4 count, and substance
abuse. Analysis was conducted by non-parametric measures and multivariate
linear regression (MLR).
Results: A total of 413 HIV+ and 145 HIV/HCV-co-infected
patients initiated therapy and had CD4 data available for analysis. By MLR
analysis, baseline CD4 count as a predictor of CD4 count recovery was
consistently significant when controlled for HCV status, intravenous drug use
(IDU) history and alcohol use history. HCV, IDU, and alcohol use impede CD4
recovery at month 3 (p <0.05 for each) but not thereafter.
|
Table 1:
HCV Status
|
Median Increase in CD4 Count from Baseline
(cells/μL)
|
|
Month 3
|
Month 6
|
Month 9
|
Month 12
|
|
HIV
|
84
|
106
|
131
|
137
|
|
HIV/HCV
|
46
|
79
|
96
|
93
|
|
p Value
|
0.01
|
0.05
|
0.04
|
0.05
|
|
Table 2:
CD4 Count at Baseline
|
Median Increase in CD4 Count from Baseline
(cells/μL)
|
|
Month 3
|
Month 6
|
Month 9
|
Month 12
|
|
CD4 <200
|
84
|
113
|
136
|
169
|
|
CD4 200 to 349
|
75
|
104
|
123
|
118
|
|
CD4 350+
|
44
|
88
|
95
|
80
|
|
p Value
|
0.002
|
0.09
|
0.02
|
0.001
|
Conclusions: HCV status has little direct influence
on long-term CD4 count recovery. Any differences between HIV/HCV-co-infected
and HIV-infected patients is likely explained primarily by baseline CD4 count
and to a lesser extent by concurrent substance abuse.
|
