@article{bb701e5370d44f21855014cbf8d91348,
title = "Has the rate of CD4 cell count decline before initiation of antiretroviral therapy changed over the course of the Dutch HIV epidemic among MSM?",
abstract = "Studies suggest that the HIV-1 epidemic in the Netherlands may have become more virulent, leading to faster disease progression if untreated. Analysis of CD4 cell count decline before antiretroviral therapy (ART) initiation, a surrogate marker for disease progression, may be hampered by informative censoring as ART initiation is more likely with a steeper CD4 cell count decline. Development of CD4 cell count from 9 to 48 months after seroconversion was analyzed using a mixed-effects model and 2 models that jointly modeled CD4 cell counts and time to censoring event (start ART, <100 CD4 cells/mm³, or AIDS) among therapy-na{\"i}ve MSM HIV-1 seroconverters in the Netherlands. These models make different assumptions about the censoring process. All 3 models estimated lower median CD4 cell counts 9 months after seroconversion in later calendar years (623, 582, and 541 cells/mm³ for 1984-1995 [n = 111], 1996-2002 [n = 139], and 2003-2007 seroconverters [n = 356], respectively, shared-parameter model). Only the 2 joint-models found a trend for a steeper decline of CD4 cell counts with seroconversion in later calendar years (overall p-values 0.002 and 0.06 for the pattern-mixture and the shared-parameter model, respectively). In the shared-parameter model the median decline from 9 to 48 months was 276 cellsmm³ for 1984-1995 seroconverters and 308 cells/mm³ for 2003-2007 seroconverters (difference in slope, p = 0.045). Mixed-effects models underestimate the CD4 cell decline prior to starting ART. Joint-models suggest that CD4 cell count declines more rapidly in patients infected between 2003 and 2007 compared to patients infected before 1996",
author = "Luuk Gras and Geskus, {Ronald B.} and Suzanne Jurriaans and Margreet Bakker and {van Sighem}, Ard and Daniela Bezemer and Christophe Fraser and Prins, {Jan M.} and Ben Berkhout and {de Wolf}, Frank and {AUTHOR GROUP} and Kuijpers, {T. W.} and Scherpbier, {H. J.} and K. Boer and {van der Meer}, {J. T. M.} and Wit, {F. W. M. N.} and Godfried, {M. H.} and P. Reiss and {van der Poll}, T. and Nellen, {F. J. B.} and Lange, {J. M. A.} and Geerlings, {S. E.} and {van Vugt}, M. and Vrouenraets, {S. M. E.} and D. Pajkrt and Bos, {J. C.} and {van der Valk}, M. and G. Schreij and S. Lowe and {Oude Lashof}, A. and Pronk, {M. J. H.} and B. Bravenboer and {van der Ende}, {M. E.} and {de Vries-Sluijs}, {T. E. M. S.} and Schurink, {C. A. M.} and {van der Feltz}, M. and Nouwen, {J. L.} and Gelinck, {L. B. S.} and A. Verbon and Rijnders, {B. J. A.} and {van de Ven-de Ruiter}, {E. D.} and L. Slobbe and Kauffmann, {R. H.} and Schippers, {E. F.} and Groeneveld, {P. H. P.} and Alleman, {M. A.} and Bouwhuis, {J. W.} and {ten Kate}, {R. W.} and R. Soetekouw and Kroon, {F. P.} and {van den Broek}, {P. J.} and {van Dissel}, {J. T.} and Arend, {S. M.} and {van Nieuwkoop}, C. and {de Boer}, {M. G.J.} and H. Jolink and {den Hollander}, {J. G.} and K. Pogany and W. Bronsveld and W. Kortmann and {van Twillert}, G. and {van Houte}, {D. P.F.} and Pol{\'e}e, {M. B.} and {van Vonderen}, {M. G.A.} and {ten Napel}, {C. H.H.} and Kootstra, {G. J.} and K. Brinkman and Blok, {W. L.} and Frissen, {P. H.J.} and Schouten, {W. E.M.} and {van den Berk}, {G. E.L.} and Juttmann, {J. R.} and {van Kasteren}, {M. E.E.} and Brouwer, {A. E.} and Mulder, {J. W.} and {van Gorp}, {E. C.M.} and Smit, {P. M.} and S. Weijer and {van Eeden}, A. and Verhagen, {D. W.M.} and Sprenger, {H. G.} and R. Doedens and Scholvinck, {E. H.} and {van Assen}, S. and Stek, {C. J.} and Hoepelman, {I. M.} and T. Mudrikova and Schneider, {M. M.E.} and Jaspers, {C. A.J.J.} and Ellerbroek, {P. M.} and Peters, {E. J.G.} and Maarschalk-Ellerbroek, {L. J.} and Oosterheert, {J. J.} and Arends, {J. E.} and Wassenberg, {M. W.M.} and {van der Hilst}, {J. C.H.} and C. Richter and {van der Berg}, {J. P.} and Gisolf, {E. H.}",
year = "2013",
month = may,
day = "27",
doi = "https://doi.org/10.1371/journal.pone.0064437",
language = "English",
volume = "8",
pages = "e64437",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",
}