Objective: A minority of PLWHA experience poor CD4+ T cell recovery while achieving virological suppression (VS), known as immune non-response (INR). The clinical outcomes of serious non-AIDS-related events (SNAE) in INR population remain poorly understood. This study assessed INR clinical outcomes, focusing on SNAE in PLWHA on ART with VS. Design: Multicenter, retrospective cohort study Methods: PLWHA aged ≥ 20 years, who received ART, had at least two consecutive HIV-1 viral load tests, and were followed for at least 24 months between January 1997 and March 2023 were included. The primary outcome was the incidence of SNAE between the INR group CD4 < 350 cells/µL after sustained VS of < 50 copies/mL for ≥ 2 years and a non-INR group with adequate immune recovery. Result: Total of 1,457 PLWHA were included. The prevalence of INR was 433 (29.7%). Male sex, older age, lower BMI, lower CD4 count at diagnosis, earlier treatment era, and the presence of comorbidities were significantly more common in the INR group than in the non-INR group. After 2 years of sustained VS, the median follow up time was 7.9 (4.4-12.2) yrs. The incidence of SNAE during follow up was 1.06/100 person-year in the INR group compared to 0.85/100 in the non-INR group (HR 1.20, 95% CI 0.79-1.82, p=0.406) INR was not significantly associated with SNAE (aHR 1.05, 95% CI 0.68 - 1.63, p=0.822). Conclusion: INR was not associated with increased SNAE incidence, suggesting it may not independently predict SNAE in PLWHA with sustained VS.
Suteetamrong et al. (Fri,) studied this question.
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