EACS2023: 834 Investigation of the causes of suboptimal CD4 cell response in advanced stage HIV patients receiving antiretroviral therapy F. Demir , A. Ari , H. Özkan Özdemir , S. Tosun University of Health Sciences. Bozyaka Education and Research Hospital, Clinical Microbiology and Infectious Diseases, İzmir, Turkey General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: While virological suppression is achieved with regular drug use in some patients, their CD4 cell count remains suboptimal. The aim of our study is to determine the rate of the patients in the population with a suboptimal CD4 cell response despite viral suppression and to investigate possible factors that may cause this situation. Method: We conducted a retrospective analysis of 455 HIV-infected patients receiving antiretroviral therapy at a tertiary healthcare center from 2010-2022. Patient baseline HIV viral load, baseline CD4 cell count, type of antiretroviral therapy initiated and status of AIDS-defining illness at baseline were recorded. A suboptimal CD4 cell response was defined as an increase in CD4 cell counts of less than 100 cells/mm³ in one year or below 200 cells/mm³ in one year despite successful viral suppression with appropriate antiretroviral therapy.Data analysis was performed using the SPSS 21 program. p<0.05 was accepted as statistical significance. Results: Our study included 98 patients whose initial CD4 cell count was less than 350 cells/mm³ or who had AIDS-defining disease, had viral suppression and had their CD4 cell count checked at 12 months. Twenty six of the 98 patients (26.5%) had a CD4 cell count below 200/mm3 or had a CD4 cell count that increased by less than 100/mm³ compared to their initial count. In our analysis, low CD4 cell count, high HIV viral load, syphilis co-infection and presence of AIDS-defining disease, all at the time of the diagnosis, were found to be statistically significant risk factors for suboptimal CD4 cell response (p<0.05). Risk factor 12. month optimal CD4 cell response 12. month suboptimal CD4 cell response N Univariate analysis P Multivariate analysis P CD4<50 CD<100 Old (medyan, min-max) 34,5 (18-67) 37,5 (19-62) 0,581 Sex Man Woman Transgender 59 7 6 21 4 1 80 11 7 0,747 Drug user Yes No 20 51 7 17 27 68 0,92 BMI (medium ± standart sapma) 22,9 ± 4,9 20,9 ± 5,6 0,12 Smoke Yes No 45 26 14 11 59 37 0,51 Syphilis Positive Negative 9 63 9 15 18 78 0,006 0,057 0,063 Baseline HIV viral load (copy/ml) <500 000 > 500 000 51 21 11 15 62 36 0,01 0,887 0,986 Baseline CD4 cell count (cell/mm3) <50 >50 4 68 13 13 17 81 0,000 0,003 <100 >100 8 64 15 15 23 79 0,000 0,001 AIDS- defining disease Yes No 4 65 7 16 11 81 0,002 0,604 0,81 Conclusions: The risk factors for suboptimal CD4 cell response in advanced HIV patients receiving antiretroviral therapy include low CD4 cell count, high HIV viral load, syphilis co-infection, and AIDS-defining disease at diagnosis. The most significant risk factor is low initial CD4 cell count. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 1 1 1 1 163
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