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Global Trends in CD4 Cell Count at the Start of Antiretroviral Therapy: Collaborative Study of Treatment Programs.

dc.rights.licenseopenen_US
dc.contributor.authorANDEREGG, Nanina
dc.contributor.authorPANAYIDOU, Klea
dc.contributor.authorABO, Y
dc.contributor.authorALEJOS, B.
dc.contributor.authorALTHOFF, K. N.
dc.contributor.authorANASTOS, K
dc.contributor.authorANTINORI, A
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBALESTRE, Eric
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBECQUET, Renaud
dc.contributor.authorCASTAGNA, Antonella
dc.contributor.authorCASTELNUOVO, B
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorCHENE, Genevieve
dc.contributor.authorCOELHO, L.
dc.contributor.authorCOLLINS, I.J.
dc.contributor.authorCOSTAGLIOLA, D.
dc.contributor.authorCRABTREE-RAMÍREZ, B.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDABIS, Francois
dc.contributor.authorD’ARMINIO MONFORTE, A.
dc.contributor.authorDAVIES, M. A.
dc.contributor.authorDELPECH, V.
dc.contributor.authorDE LA MATA, N.L.
dc.contributor.authorDUDA, S.
dc.contributor.authorFREEMAN, A.
dc.contributor.authorGANGE, S.J.
dc.contributor.authorGRABMEIER-PFISTERSHAMMER, K.
dc.contributor.authorGUNSENHEIMER-BARTMEYER, B
dc.contributor.authorJIAMSAKUL, A.
dc.contributor.authorKITAHATA, M.M.
dc.contributor.authorLAW, M.
dc.contributor.authorMANZARDO, C.
dc.contributor.authorMCGOWAN, C.
dc.contributor.authorMOORE, R. D.
dc.contributor.authorMUSSINI, C
dc.contributor.authorNAKIGOZ, G.
dc.contributor.authorNASH, D.
dc.contributor.authorNG, O.T.
dc.contributor.authorOBEL, N.
dc.contributor.authorPANTAZIS, N.
dc.contributor.authorPODA, A.
dc.contributor.authorRABEN, D.
dc.contributor.authorREISS, P.
dc.contributor.authorRIGGEN, L.
dc.contributor.authorSABIN, C.
dc.contributor.authorD’AMOUR SINAYOBYE, J.
dc.contributor.authorSÖNNERBORG, A.
dc.contributor.authorSTOECKLE, M.
dc.contributor.authorTHORNE, C.
dc.contributor.authorTORTI, C.
dc.contributor.authorTWIZERE, C.
dc.contributor.authorWASMUTH, J.-C.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorWITTKOP, Linda
dc.contributor.authorWOOLS-KALOUSTIAN, K.
dc.contributor.authorYOTEBIENG, M.
dc.contributor.authorKIRK, O.
dc.contributor.authorEGGER, M.
dc.date.accessioned2020-06-26T13:24:17Z
dc.date.available2020-06-26T13:24:17Z
dc.date.issued2018-03-05
dc.identifier.issn1537-6591en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/8226
dc.description.abstractEnEarly initiation of combination antiretroviral therapy (cART), at higher CD4 cell counts, prevents disease progression and reduces sexual transmission of human immunodeficiency virus (HIV). We describe the temporal trends in CD4 cell counts at the start of cART in adults from low-income, lower-middle-income, upper-middle-income, and high-income countries (LICs, LMICs, UMICs, and HICs, respectively). We included HIV-infected individuals aged ≥16 years who started cART between 2002 and 2015 in a clinic participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) or the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE). Missing CD4 cell counts at the start of cART were estimated through multiple imputation. Weighted mixed-effect models were used to smooth trends in median CD4 cell counts. A total of 951855 adults from 16 LICs, 11 LMICs, 9 UMICs, and 19 HICs were included. Overall, the modeled median CD4 cell count at the start of cART increased from 2002 to 2015, from 78/µL (95% confidence interval, 58-104/µL) to 287/µL (250-328/µL) in LICs, from 99/µL (71-140/µL) to 234/µL (192-285/µL) in LMICs, from 71/µL (49-104/µL) to 311/µL (255-379/µL) in UMICs, and from 161/µL (143-181/µL) to 327/µL (286-372/µL) in HICs. In LICs, LMICs, and UMICs, the increase was more pronounced in women; in HICs, the opposite was observed. Median CD4 cell counts at the start of cART increased in all income groups, but generally remained below 350/μL in 2015. Substantial additional efforts and resources are required to achieve earlier diagnosis, linkage to care, and initiation of cART.
dc.language.isoENen_US
dc.subjectAdult
dc.subjectAnti-HIV Agents
dc.subjectAntiretroviral Therapy
dc.subjectHighly Active
dc.subjectCD4 Lymphocyte Count
dc.subjectCohort Studies
dc.subjectDisease Progression
dc.subjectEurope
dc.subjectFemale
dc.subjectGlobal Health
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectIncome
dc.subjectInternational Cooperation
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPoverty
dc.subjectPractice Guidelines as Topic
dc.subjectWorld Health Organization
dc.titleGlobal Trends in CD4 Cell Count at the Start of Antiretroviral Therapy: Collaborative Study of Treatment Programs.
dc.title.alternativeClin Infect Disen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/cid/cix915en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29373672en_US
bordeaux.journalClinical Infectious Diseasesen_US
bordeaux.page893-903en_US
bordeaux.volume66en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue6en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamMORPH3Eus
bordeaux.teamIDLIC
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.identifierhal-02882246
hal.version1
hal.date.transferred2020-06-26T13:24:25Z
hal.exporttrue
workflow.import.sourcedissemin
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