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Abstract
VIROLOGICAL RESPONSE IN RESERVOIRS IN HIV-INFECTED NAIVE PATIENTS TREATED WITH COMBIVIR PLUS NELFINAVIR (CNF) OR NEVIRAPINE (CNR).
FERRER E, PODZAMCZER D, PEREZ P, PEREZ J, ESTELA J, MAÑOS M, LOZANO L, SOLE R, MARTÍNEZ - LA CASA J, CASADO A
Background: Nonnucleoside reverse transcriptase inhibitors are now widely used as part of a first choice HAART regimen, but data about their anti-HIV-1 activity in reservoirs and its comparison with protease inhibitors are scanty.
Methods: A substudy evaluating the virological response of two HAART combinations (CNf or CNr) in tonsillar lymphoid tissue (LT), cerebrospinal fluid (CSF) and semen was performed in voluntary pts participating in a randomized, open, multicenter trial (Combine study). HIV-1 RNA (viral load (VL)) was determined by PCR (plasma, semen and CSF) or bDNA (LT) techniques according to published protocols. It was programmed to obtain samples at months 0, 6 and 12 in pts who continued with the initially allocated regimen.
Results: VL was determined in LT in 14 pts (7 CNf, 7 CNr), in CSF in 17 pts (9 CNf, 8 CNr) and in semen in 18 pts (9 CNf, 9 CNr). Median baseline VL in LT was 7.24 (6.77-7.38) log 10 equivalents/gram, and in CSF 3.16 (2.29-4.21) log10 copies/mL. In only 2 pts VL was determined in semen at baseline (81,860 and 1,902 copies/mL). In all the CSF (n=15 at 6 months and n=8 at 12 months) and semen (n=14 at 6 months and n=6 at 12 months) studied samples, less than 200 copies/mL were found during follow-up. Regarding LT samples, a reduction of at least 3.5 log10 equivalents/gram was observed in each arm at 6 months (n=14) and at 12 months (n=8). Undetectable VL levels were observed in 2/14 pts at 6 months (1 in each arm) and in 3/8 at 12 months (1 CNf, 2 CNr). In 2 pts (1 in each arm) a rebound in VL was observed in LT at 12 months. while plasma VL was < 20 copies/mL. Three months later plasma VL remained < 20 copies/mL in one and rose to 43 copies/mL in the other.
Conclusions: Both CNf and CNr achieve a virological response in reservoirs. However, anti HIV-1 activity may be suboptimal in lymphoid tissue, at least in some pts. The long term clinical significance of a rebound in HIV-1 RNA in LT and not in plasma is unclear.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
28
Suggested Citation
"FERRERE, et al.
VIROLOGICAL RESPONSE IN RESERVOIRS IN HIV-INFECTED NAIVE PATIENTS TREATED WITH COMBIVIR PLUS NELFINAVIR (CNF) OR NEVIRAPINE (CNR)..
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
28"
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