The prevalence of HIV-infected patients with virological suppression but a CD4+ T-cell count of ≤ 200 cells/mm3 after highly active antiretroviral therapy initiation: A meta-analysis

Highly active antiretroviral therapy (HAART) strongly inhibits HIV replication. However, many patients show suboptimal immune recovery (SIR), as defined by virological suppression (i.e. low viral load) with a CD4⁺ T-cell count of ≤ 200 cells/mm³, after HAART initiation. Here, we performed a systematic evaluation of the SIR prevalence among HIV-infected patients in cohort studies. We searched PubMed, Cochrane Library, Embase, CNKI, Wanfang database, and Chinese Biomedicine Database for cohort studies about HIV-infected participants whose CD4⁺ T-cell count was ≤ 200 cells/mm³ but still had virological suppression after HAART initiation. The SIR prevalence from each of those cohort studies was pooled into a random-effect meta-analysis. We obtained two kinds of pooled post-HARRT initiation SIR prevalence: one among participants with virological suppression (11 cohort studies involving 18,672 participants), and the other among all HIV-infected participants (seven cohort studies involving 12,063 participants). The pooled SIR prevalence among HIV-infected patients with virological suppression after HAART initiation was 43% (95% confidence interval [CI], 34–51%) at 6 months post-HAART initiation and 10% (95% CI, 5–18%) at 36 months post-HAART initiation; among all HIV-infected patients after HAART initiation, it was 17% (95% CI, 0–55%) and 5% (95% CI, 2–10%) at 6 and 36 months post-HAART initiation, respectively. The SIR prevalence among HIV-infected patients is high at 6 months post-HAART initiation, but its prevalence gradually reduces over time under continuous HAART. Thus, it is important to follow-up on variations in the CD4⁺ T-cell count and viral load.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Treatment