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The predictive role of CD4+ cell count and CD4/CD8 ratio in immune reconstitution outcome among HIV/AIDS patients receiving antiretroviral therapy: An eight-year observation in China

BMC Immunology Sep 03, 2019

Li CX, Li YY, He LP, et al. - Given a substantial impact of immune reconstitution following the start of highly active antiretroviral therapy (HAART) on the prognosis of HIV-infected individuals, researchers intended to gain clarity on the dynamic features as well as predictors of reconstitution outcome. Participants were HIV/AIDS patients with sustained virological suppression (viral load < 50 copies/ml) post-HAART. Findings revealed immune reconstitution failure can be reduced by early initiation of HAART. According to receiver operating characteristic curve, the highest predictive value was displayed by 1-year CD4+ cell count. With the best cut-off value of 188 cells/μl, the estimated predictive sensitivity and predictive specificity were 81.0% and 85.2%, respectively; false positive rate, false negative rate, positive predictive value (immunological responder) and negative predictive value (immunological non-responder) were 14.8%, 19.0%, 63.0%, and 93.5%, respectively. Overall, experts concluded that baseline CD4+ cell count in combination with baseline CD4/CD8 ratio may be used as a valid predictor of immune reconstitution prognosis post-HAART.

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