Factors Associated with Immunological Non-response After ART Initiation: a Retrospective Observational Cohort Study

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2024 Jan 29

PMID 38287246

Authors

Heping Zhao

Anping Feng

Dan Luo

Tanwei Yuan

Yi-Fan Lin

Xuemei Ling

Huolin Zhong

Junbin Li

Linghua Li

Huachun Zou

Affiliations

Soon will be listed here.

Abstract

Background: Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented.

Methods: We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months' treatment), immunological incomplete responders (ICRs) (200-350 cells/μl) and INRs (< 200 cells/μl). Multivariable logistic regression was used to assess factors associated with immunological non-response.

Results: A total of 3900 PLHIV were included, among whom 2309 (59.2%) were IRs, 1206 (30.9%) ICRs and 385 (9.9%) INRs. In multivariable analysis, immunological non-response was associated with being male (2.07, 1.39-3.09), older age [40-49 years (vs. 18-29 years): 2.05, 1.29-3.25; 50-59 years: 4.04, 2.33-7.00; ≥ 60 years: 5.51, 2.84-10.67], HBV co-infection (1.63, 1.14-2.34), HCV co-infection (2.01, 1.01-4.02), lower CD4 + T cell count [50-200 cells/μl (vs. 200-350 cells/μl): 40.20, 16.83-96.01; < 50 cells/μl: 215.67, 85.62-543.26] and lower CD4/CD8 ratio (2.93, 1.98-4.34) at baseline. Compared with patients treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens, those receiving protease inhibitors (PIs) based regimens were less likely to be INRs (0.47, 0.26-0.82).

Conclusions: We found a sizable immunological non-response rate among HIV-infected patients. Being male, older age, coinfection with HBV and HCV, lower CD4 + T cell count and lower CD4/CD8 ratio are risk factors of immunological non-response, whereas PIs-based regimens is a protective factor.

Citing Articles

Cytokine profiles and CD4 counts in HIV-positive individuals with cysticercosis: implications for sex-specific immune responses in co-endemic regions of Tanzania.

Lema Y, Prodjinotho U, Makasi C, Nanyaro M, Kilale A, Godfrey Mfinanga S Front Immunol. 2025; 16:1521295.

PMID: 40046043 PMC: 11880214. DOI: 10.3389/fimmu.2025.1521295.

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