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AIDS. 2005 Feb 18;19(3):331-5.

Changes over time in post-seroconversion CD4 cell counts in the Italian HIV-Seroconversion Study: 1985-2002.

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  • 1Reparto di Epidemiologia, Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Rome, Italy. marie.dorrucci@iss.it

Abstract

OBJECTIVE:

To determine whether there has been a tendency for early post-seroconversion CD4 cell counts to change over calendar time.

DESIGN:

A prospective cohort study of individuals with well-estimated dates of seroconversion.

METHODS:

We studied 1251 individuals who seroconverted to HIV in Italy between 1985 and 2002, and for whom the first CD4 count was measured within 2 years of seroconversion and before any use of antiretrovirals. Linear regression models were used to assess evidence for a trend in post-seroconversion CD4 cell count over time.

RESULTS:

The median post-seroconversion CD4 cell count was 674 x 10 cells/l in those seroconverting between 1985 and 1990, 588 x 10 cells/l for 1991 to 1994, 559 x 10 cells/l for 1995 to 1998 and 494 x 10 cells/l for 1999 to 2002. The post-seroconversion CD4 cell count decreased by an average of 8.4 x 10 cells/l per year (95% confidence interval, 4.0-12.9; P < 0.001), after adjustment for potential confounders, including interval between HIV-negative and HIV-positive tests, lag time for first CD4 cell count measurement, age at seroconversion, gender, HIV-transmission group, and clinical centre. The finding was consistent in sensitivity analyses restricted to those with information on acute infection.

CONCLUSION:

These data suggest a possible decreasing trend in CD4 cell count immediately following seroconversion in Italy which requires further investigation.

PMID:
15718844
[PubMed - indexed for MEDLINE]
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