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Definition of immunological nonresponse to antiretroviral therapy: A systematic review

Journal of Acquired Immune Deficiency Syndromes Nov 21, 2019

Rb-Silva R, Goios A, Kelly C, et al. - Given the heterogeneity in terms and criteria to classify people living with HIV on antiretroviral therapy who fail to achieve satisfactory CD4+ T-cell counts, researchers sought to perform revision and summarization of these terminology and criteria. Searching PubMed original research articles containing a set of predefined terms, published in English between January 2009 and September 2018, they identified 103 eligible studies for this work. They identified 22 terms and 73 criteria to define the condition. This indicates a high disparity in terms and criteria that hinders data aggregation and progression of the knowledge on this condition as it renders impossible to compare data from different studies. “Immunological nonresponders” was the most frequent term used and “CD4+ T-cell count < 350 cells/µL after ≥ 24 months of virologic suppression” was the most frequent criterion employed. CD4+ T-cell counts were used by most criteria use as a surrogate, either as an absolute value before antiretroviral therapy initiation or as a change after a defined period of time. Distinct values and time points were employed. The use of only 9 of the 73 criteria was reported by more than one independent research team. Two criteria were proposed in this work that could aid to reach a consensus.
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