Japanese Journal of Infectious Diseases
Online ISSN : 1884-2836
Print ISSN : 1344-6304
ISSN-L : 1344-6304

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Factors Associated with Immunological Discordance in HIV-infected Patients Receiving Antiretroviral Therapy with Complete Viral Suppression in A Resource-limited Setting
Pornpimol MingbunjerdsukNakhon AsdamongkolSomnuek Sungkanuparph
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論文ID: JJID.2014.062

この記事には本公開記事があります。
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Immunological failure despite complete viral suppression in HIV-infected patients receiving antiretroviral therapy (ART), referred to as ``immunological discordance'', is associated with increased risk of AIDS or death. We aimed to evaluate the risk factors for immunological discordance in a resource-limited setting where patients usually present late with low CD4 cell counts. A case-control study was conducted among HIV-infected patients receiving ART and having undetectable HIV RNA. Cases were patients who had immunological discordance, which was defined as CD4 cell count increased <30% from baseline and absolute CD4 cell count was <200 cells/mm3 at the first 12 months of undetectable HIV RNA (<50 copies/mL). Matched controls were patients without immunological discordance. Of 142 patients (44 cases; 98 controls), the mean age was 38.6±9.4 years and 67.6% were males; 65.5% had history of opportunistic infections. In multivariate analysis, only baseline CD4 cell count <100 cells/mm3 [Odd ratio (OR) 2.53; 95% confidence interval (CI), 1.04-6.14; p=0.040] and history of lost to follow-up [OR 11.04; 95% CI, 2.87-42.46; p <0.001] were significantly associated with immunological discordance. Early initiation of ART and intervention to improve regular clinic visit and adherence to ART are crucial management to prevent immunological discordance among HIV-infected patients.

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