CD4 Monitoring for People With HIV Could Be Reduced to Every 6 to 12 Months

July 1, 2016

At least in the short term, reducing CD4 monitoring among those with stable HIV suppression from every three months to every six to 12 months appears safe, not leading to any additional AIDS-defining illnesses or death, aidsmap reports. Publishing their findings in the Journal of Acquired Immune Deficiency Syndromes, researchers from the HIV-CAUSAL Collaboration studied data on 39,029 people with HIV who participated in six observational cohort studies in Europe and the United States, started antiretrovirals (ARVs) for the first time and were virologically suppressed within 12 months.

A total of 265 of the individuals died during the studies’ follow-up periods. There were 690 cases of the composite outcome of death or AIDS-defining illnesses.

Compared with monitoring CD4s every three months, doing so every nine months was associated with a 14 percent lower risk of death, and doing so every 12 months was associated with an 18 percent lower risk of death. However, these differences were not statistically significant, meaning they could have occurred by chance.

The risk of experiencing virologic failure (a viral load greater than 200) after 18 months was 26 percent lower among those monitored every nine months (not a statistically significant difference) and 2.35-fold greater among those monitored every 12 months (a statistically significant difference), compared with three-month monitoring.

Compared with three-month monitoring, the average difference in CD4 count was a respective 5.3 fewer CD4s (not statistically significant) and 31.7 fewer CD4s (a statistically significant difference) among those monitored every nine and 12 months.

The rates of AIDS-defining illness or death were similar across all three monitoring intervals.

“Our findings suggest that monitoring frequency of virologically suppressed individuals can be decreased from every three months to every six, nine or 12 months with respect to clinical outcomes,” the study authors concluded. “Because effects of different monitoring strategies could take years to materialize, longer follow-up is needed to fully evaluate this question.”

To read the aidsmap article, click here.

To read the study abstract, click here.

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