Dr Sension underlines the value of CD4 recovery from payer and clinician perspectives.
Ryan Haumschild, PharmD, MS, MBA: It’s important that we talk about CD4 recovery and how it’s important to the treatment of multidrug-resistant HIV. Dr Sension, can you talk about CD4 recovery? What are the benefits of CD4 recovery? And what are the implications of not recovering a patient’s CD4 count in a heavily treatment-experienced patient, both from the clinician and payer perspectives?
Michael Sension, MD: We’ve seen time and again, when you can achieve virological suppression, your T cells go up. How much? That remains to be seen. There are some interesting results with fostemsavir. We see an unexpected CD4 cell count rise, particularly with that medication. Whether it’s fostemsavir, ibalizumab, or lenacapavir, there was attention—in all the clinical trials that led to the approval of those 3 medications—to where people were before they started the medication and where they ended up 1, 2, 3 years later in terms of their CD4 cell counts. They specifically paid attention to people who had low T-cell counts—below 50 cells/mm3, below 200 cells/mm3—and the percentage of individuals who still had low T-cell counts 6 months, 1 year, and 2 years later. The results were promising in all 3 clinical trials, which showed that when you achieve virological suppression with the new agent, fewer individuals were in this more severe immunosuppressed state. Why is that important? Because we historically have associated low CD4 counts with more vulnerability to developing opportunistic infections and life-threatening situations due to immunosuppression. When individuals get over a certain threshold—it’s been thought to be around 200 cells/mm3—they’re out of the danger zone for severe immunosuppressive events.
Transcript edited for clarity.
ATS 2024 Data Support Triple Therapy FF/UMEC/VI as Preferred Option for COPD
May 21st 2024New data reveal that starting furoate/umeclidinium/vilanterol (FF/UMEC/VI) without delay not only significantly reduces exacerbations and health care costs but also enhances adherence and persistence for patients with chronic obstructive pulmonary disease (COPD) compared with other therapies.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Unique Case: HCC With No Cirrhosis—and “Hidden” CLL/SLL
May 21st 2024A 77-year-old man had no risk factors for hepatocellular carcinoma (HCC), but he was nonetheless found to have it. Along the way, he was also diagnosed with previously undetected chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
Read More
Exploring Critical Advances in ARDS, Asthma, Lung Cancer, Health Equity at ATS 2024
May 20th 2024During a session at the American Thoracic Society (ATS) 2024 International Conference, experts presented the most impactful data from the last year on acute respiratory distress syndrome (ARDS), childhood asthma, health equity, and lung cancer.
Read More
Patients With COPD, PRISm at Increased All-Cause, Cause-Specific Mortality Risk
May 20th 2024Patients with chronic obstructive pulmonary disease (COPD) and/or preserved ratio impaired spirometry (PRISm) have an increased risk of all-cause and cause-specific mortality, highlighting the need for better understanding of these conditions through increased spirometry data collection.
Read More