Effect of tuberculosis on immune restoration among HIV-infected patients receiving antiretroviral therapy

Abstract

ABSTRACTIn this article, time to immune recovery during antiretroviral therapy was estimated and compared between HIV-infected children with and without tuberculosis (TB). CD4 T-cell restoration was used as a criterion for determining immune recovery. The median residual lifetime function, which is more intuitive and robust compared to the frequently used measures of lifetime data, was used to estimate time to CD4 T-cell restoration. The median residual lifetime is not influenced by extreme observations and heavy-tailed distributions which are commonly encountered in clinical studies. Permutation-based methods were used to compare the CD4 T-cell restoration times between the two groups of patients. Our results indicate that children with TB had uniformly higher median residual lifetimes to immune recovery compared to those without TB. Although TB was associated with slower CD4 T-cell restoration, the differences between the restoration times of the two groups were not statistically significant.