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Abstract
VIROLOGICAL AND IMMUNOLOGICAL EFFECTS OF DISCONTINUATION OF ANTIRETROVIRAL THERAPY IN HIV-POSITIVE PATIENTS WITH VIROLOGICAL FAILURE AND A CD4 COUNT ABOVE 500 CELLS/ML
MUSSINI C, BUGARINI R, PERNO C, ANTINORI A, BORGHI V, COSSARIZZA A, ESPOSITO R
Object of the study: To evaluate in patients who fail a current regimen with a high CD4 count and that discontinue therapy instead of changing it, virological effects and how long they would stay out of treatment before reaching a CD4 count below 350 cells/mL.Methods: In patients treated with antiretrovirals who had an HIV plasma viral load >3 log10 copies/mL with a CD4 count >500 cells/mL it was discontinued antiretroviral therapy. A mixed model with a random intercept and an autoregressive variance-covariance structure for patient was used to detect changes in CD4 count and HIV RNA plasma level over time. To model different slopes of changes in CD4 and HIV RNA plasma level on time was used a spline regression.Results: 16 HIV positive patients discontinued antiretroviral therapy. The median duration of treatment before discontinuation was: 36 months and all patients reached an undetectable viral load. During treatment patients experienced a mean CD4 count increase of 7.6 cells/mL per month and a mean HIV plasma viral load decrease of 0.018 log10 per month. At discontinuation median CD4 count was: 755 cells/mL and the median HIV plasma viral load was: 3.38 log10. The median observation time was: 8 months (range: 2-15 months). In the first six months, CD4 count showed a decrease of 46.2 cells/mL per month, and after then, a decrease of 10.2 cells/mL per month. HIV plasma viral load, in the first 6 months showed a mean increase 0.22 log10 per month and after then a mean increase of 0.08 (p=0.07) log10 per month. Drug susceptibility was assessed using genotipic analysis on all samples before and after discontinuation. Conclusions: This study shows that if antiretroviral therapy is discontinued in patients with virological failure and a high CD4 count in most of them there is a rapid and severe decrease in CD4 count.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
110
Suggested Citation
"MUSSINIC, et al.
VIROLOGICAL AND IMMUNOLOGICAL EFFECTS OF DISCONTINUATION OF ANTIRETROVIRAL THERAPY IN HIV-POSITIVE PATIENTS WITH VIROLOGICAL FAILURE AND A CD4 COUNT ABOVE 500 CELLS/ML.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
110"
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