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TL;DR
It found that CD4 recovery after restarting ART is much slower compared to the initial response after starting ART.
American Journal of Epidemiology · 8 authors
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It found that CD4 recovery after restarting ART is much slower compared to the initial response after starting ART.
A linear mixed model was used to jointly estimate CD4 trends before disengagement, during the treatment gap, and after ART reinitiation. The median gap in care was 2.7 months. The central result was that CD4 cell-count increases after ART reinitiation were significantly slower than before disengagement. For a hypothetical scenario of disengagement 12 months after ART start with a 3-month gap, the modeled CD4 count at 3 years was 36.5 cells/μL lower than if care had been continuous. Limitations include potential selection bias (only included those who returned to care), possible unmeasured intermittent adherence, and assumptions about missing data. The findings underscore that even short treatment interruptions are detrimental to long-term immune recovery, highlighting the critical need for interventions to improve retention in care.