Immune Pir

Factors associated with paradoxical immune response to antiretroviral therapy in HIV infected patients: a case control study. (biomedcentral)

Background: A paradoxical immunologic response (PIR) to Highly Active
Antiretroviral Therapy (HAART), defined as viral suppression without CD4 cell-
count improvement, has been reported in the literature as 8 to 42%, around 15%
in most instances. The present study aims to determine, in a cohort of HIV
infected patients in Brazil, what factors were independently associated with
such a discordant response to HAART. Methods: A case-control study (1:4)
matched by gender was conducted among 934 HIV infected patients on HAART in
Brazil. Cases: patients with PIR, defined as CD4 350 cells/mm3 (hazard ratio
for AIDS or death of at least 8.5)and undetectable HIV viral load on HAART for
at least one year. Controls: similar to cases, but with CD4 counts [greater
than or equal to] 350 cells/mm3. Eligibility criteria were applied. Data were
collected from medical records using a standardized form. Variables were
introduced in a hierarchical logistic regression model if a p-value 0.1 was
determined in a bivariate analysis. Results: Among 934 patients, 39 cases and
160 controls were consecutively selected. Factors associated with PIR in the
logistic regression model were: total time in use of HAART (OR 0.981; CI 95%:
0.96-0.99), nadir CD4-count (OR …

biomedcentral

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