Major study of "discordant" response--viral control but incomplete CD4 response.This important research from the Swiss HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. Cohort Study A cohort study is a form of longitudinal study used in medicine and social science. It is one type of study design. In medicine, it is usually undertaken to obtain evidence to try to refute the existence of a suspected association between cause and disease; failure to refute (1) looks at patients who responded virologically to antiretrovirals (viral load viral load n. The concentration of a virus, such as HIV, in the blood. viral load, n a measure of the number of virus particles present in the bloodstream, expressed as copies per milliliter. consistently under 1000 for at least five years) to find the differences between those who had an "incomplete" CD4 response (defined as not reaching a CD4 count CD4 count n. A measure of the number of helper T cells per cubic millimeter of blood, used to analyze the prognosis of patients infected with HIV. of 500), vs. those with a "complete" response to at least 500. Older age, lower CD4 baseline, and longer HIV infection were associated with incomplete CD4 recovery. CD4 response during the first three to six months of antiretroviral antiretroviral /an·ti·ret·ro·vi·ral/ (-ret´ro-vi?ral) effective against retroviruses, or an agent with this quality. an·ti·ret·ro·vi·ral adj. treatment was a good predictor of who would respond at five years (this study looked only at those who did control viral load to under 1,000 copies). However, this study in 293 patients did not find a statistically significant difference in number of patients who had AIDS-related events--14.4% of those with "complete" CD4 recovery and 21% incomplete, but this difference was not enough to reach the customary .05 level of statistical significance. In the future, this kind of research could help doctors and patients know what to expect from current antiretroviral treatment, avoiding unnecessary drug use or regimen switches. A 3-page editorial summary (2) published with the research report is a good place to start for understanding this study and its importance. The journal, Clinical Infectious Diseases Clinical Infectious Diseases in an academic journal published by the University of Chicago Press which publishes articles on the pathogenesis, clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment of diseases caused by infectious agents. , has made both papers available free to nonsubscribers online. Visit http://www.journals.uchicago.edu/CID/journal/available.html, select volume 41 number 3, and scroll down to click on the articles starting on pages 361 and 373. References (l) Kaufmann GR, Furrer H, Ledergerber B and others. Characteristics, determinants, and clinical relevance of CD4 T cell Noun 1. CD4 T cell - T cell with CD4 receptor that recognizes antigens on the surface of a virus-infected cell and secretes lymphokines that stimulate B cells and killer T cells; helper T cells are infected and killed by the AIDS virus recovery to <500 cellsl/[micro]L in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clinical Infectious Diseases. August 1,2005; volume 41, pages 361-372. (2) Sasson SC, Kelleher AD, and Cooper DA. The modern ART of HIV infection management: Towards a tailored approach to maximize CD4 T cell reconstitution. [editorial commentary] Clinical Infectious Diseases. August 1, 2005; volume 41, pages 373-375. |
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