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Authors: Nakanjako D , Kiragga A, Yiannoutsos C,

Suboptimal immune response among adults on first-line antiretroviral therapy within the IeDEA East Africa cohort. Authors: Nakanjako D , Kiragga A, Yiannoutsos C, Kambugu A, Easterbrook P, on behalf of IeDEA - EA. Definitions of suboptimal CD4 recovery.

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Authors: Nakanjako D , Kiragga A, Yiannoutsos C,

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  1. Suboptimal immune response among adults on first-line antiretroviral therapy within the IeDEA East Africa cohort Authors: Nakanjako D, Kiragga A, Yiannoutsos C, Kambugu A, Easterbrook P, on behalf of IeDEA- EA Abstract # TUPDB0105 IAS 30th June-3 July 2013, Kuala Lumpar Malaysia

  2. Definitions of suboptimal CD4 recovery • magnitude criteria: CD4 increase <50 cells at 6 months, <100 cells at 12 months and <200 cells at 24 months • CD4 threshold criteria:absolute CD4 count <200 cells/UL at 6, 12 and 24 months • Population-specific criteria: Lowest quartile CD4 count increases in the HAART cohort Tuboi SH, JAIDS 2007, Lawn SD, BMC ID, 2007, Lawn SD, AIDS 2001

  3. Statistical methods • Used Kaplan Meier survival analysis to analyse time to normalization (CD4 > 500 cells) • Considered competing risks of death and loss to follow-up

  4. Incidence of normalisation with competing risks of death and Loss to follow up

  5. Policy issues • Need to increase access to routine CD4 in routine HIV care & treatment programs • Routine viral loads for poor CD4 responders to identify suboptimal responder population • Increase adherence and retention in care to allow quality follow up • Interventions to optimise immune recovery among suboptimal responders despite viral suppression

  6. Acknowledgement

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