Evolution of CD4 T-Cell Count With Age in a Cohort of Young People Growing Up With Perinatally Acquired Human Immunodeficiency Virus

Castro , H; Sabin, C; Collins, I.J; Okhai, H; Schou Sandgaard , K; Prime, K; Foster , C; Le Prevost , M; Crichton, S; Klein, N; Judd , A

Evolution of CD4 T-Cell Count With Age in a Cohort of Young People Growing Up With Perinatally Acquired Human Immunodeficiency Virus

Authors

Castro , H

Sabin, C

Collins, I.J

Okhai, H

Schou Sandgaard , K

Prime, K

Foster , C

Le Prevost , M

Crichton, S

Klein, N

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Issue Date

2024

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Microbiology, immunology, infectious diseases::Immunology

Abstract

Abstract Background: Recent studies have shown a decrease in CD4 count during adolescence in young people with perinatally acquired human immunodeficiency virus (HIV, PHIV). Methods: Young people with PHIV in the United Kingdom, followed in the Collaborative HIV Paediatric Study who started antiretroviral therapy (ART) from 2000 onward were included. Changes in CD4 count over time from age 10 to 20 years were analyzed using mixed-effects models, and were compared to published CD4 data for the gerneral population. Potential predictors were examined and included demographics, age at ART start, nadir CD4 z score (age-adjusted) in childhood, and time-updated viral load. Results: Of 1258 young people with PHIV included, 669 (53%) were female, median age at ART initiation was 8.3 years, and the median nadir CD4 z score was -4.0. Mean CD4 count was higher in young people with PHIV who started ART before age 10 years and had a nadir CD4 z score ≥-4; these young people with PHIV had a decline in CD4 count after age 10 that was comparable to that of the general population. Mean CD4 count was lower in young people with PHIV who had started ART before age 10 and had a nadir CD4 z score <-4; for this group, the decline in CD4 count after age 10 was steeper over time. Conclusions: In children, in addition to starting ART at an early age, optimizing ART to maintain a higher CD4 z score during childhood may be important to maximizing immune reconstitution later in life. Keywords: CD4 T cell; HIV; adult; child; perinatal. © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. PubMed Disclaimer Conflict of interest statement Potential conflicts of interest. C. S. reports funding for membership on data and safety and monitoring boards advisory boards and for preparation of educational materials from Gilead Sciences, ViiV Healthcare, and MSD and a role as vice-chair (until the end of 2022) for the British HIV Association. C. F. reports research grants from ViiV Healthcare and Gilead Sciences. H. O. reports consulting fees to author from Gilead Sciences. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Figures Graphical Abstract Graphical Abstract This graphical abstract is also… Figure 1. Figure 1. Predicted mean CD4 counts over… Figure 2. Figure 2. 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Citation

Castro H, Sabin C, Collins IJ, Okhai H, Schou Sandgaard K, Prime K, Foster C, Le Prevost M, Crichton S, Klein N, Judd A; Collaborative HIV Paediatric Study; UK Collaborative HIV Cohort Study. Evolution of CD4 T-Cell Count With Age in a Cohort of Young People Growing Up With Perinatally Acquired Human Immunodeficiency Virus. Clin Infect Dis. 2024 Mar 20;78(3):690-701. doi: 10.1093/cid/ciad626. PMID: 37820036; PMCID: PMC10954325.