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Abstract
Persistent Low Viremia and Future Treatment Options
Dyner T.1, Boly L.1, Cafaro V.1
Introduction: Recent studies have suggested that anti-retroviral resistance may not be the major contributing factor for mortality in AIDS patients. Other studies recently suggest that low level viremia (HIV-bDNA <20,000 copies/ml) may confer clinical, i.e. immunologic benefit. Since all agree that HAART has been responsible for prolonged survival in patients with HIV disease, it may be that clinical progression from a laboratory standpoint will need to be reassessed. We reviewed a cohort of HIV infected patients with detectable viremia for the development of drug resistance and HIV related illnesses.
Methods: Charts of 30 HIV patients on stable (>24 months) dual or triple ART drug regimens with detectable HIV-bDNA levels above the level of quantification were reviewed. The patients included for analysis were those who had chosen to maintain a regimen for a variety of reasons, despite persistent viremia above the level of detection. Charts were reviewed for CD4s, HIV-bDNA levels, HIV related OIs/malignancies, as well as genotypic and/or phenotypic resistance tests.
Results: Patients were on therapy with their stable regimen an average of 68 months (range 25-102). The baseline average CD4 and HIV-bDNA for the current regimen was 415 cells/mm³ (range 38-700) and 4.2 log10 copies/ml (range<2.7-4.8 log10 ), respectively. Change in CD4 count from baseline to March 2004 averaged -1.17 cells/mm³ while the change in HIV-bDNA averaged -0.27 log10 copies/ml. Genotypic testing revealed an average increase of 1.6 point mutations; however, there were no new mutations in 1/3 of patients.
Conclusions: This cohort of patients preserved immunologic competence despite the presence of low level viremia. Future treatment options may not be jeopardized for patients who decide to continue regimens which are not fully suppressive.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
WePe12.7C02
Suggested Citation
"DynerT., et al.
Persistent Low Viremia and Future Treatment Options.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
WePe12.7C02"
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