Better Virological Outcomes Among People Living With Human Immunodeficiency Virus (HIV) Initiating Early Antiretroviral Treatment (CD4 Counts ≥500 Cells/µL) in the HIV Prevention Trials Network 071 (PopART) Trial in South Africa.

摘要: BACKGROUND There have been concerns about reduced adherence and human immunodeficiency virus (HIV) virological suppression (VS) among clinically well people initiating antiretroviral therapy (ART) with high pre-ART CD4 cell counts. We compared outcomes by count, where universal ART initiation was provided in the HIV Prevention Trials Network 071 (PopART) trial South Africa prior to routine national international implementation. METHODS This prospective cohort study included adults at facilities providing since January 2014. VS ( 1000 copies/mL), viral rebound were between participants strata of baseline count. RESULTS The sample 1901 participants. ≥94% count ≥500 cells/µL all 6-month intervals 30 months. risk an elevated load (≥400 copies/mL) independently lower (3.3%) those 200-499 (9.2%) months 18 (adjusted relative risk, 0.30 [95% confidence interval, .12-.74]; P = .010). incidence rate VF 7.0, 2.0, 0.5 per 100 person-years <200, 200-499, cells/µL, respectively (P < .0001). hazard ratio [aHR], 0.23; .045) 3-fold higher <200 (aHR, 3.49; CONCLUSIONS Despite previous concerns, counts had very good outcomes, being better than cells/µL. CLINICAL TRIALS REGISTRATION NCT01900977.