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Abstract
GREATER SUPPRESSION OF CD8 ACTIVATION WITH 4 VS 3 DRUGS IN EARLY STAGES OF PRIMARY HIV INFECTION (PHI) DESPITE SIMILAR PLASMA VIROLOGICAL DECAY RATES.
SMITH D, ZAUNDERS J, KAUFFMAN G, CUNNINGHAM P, GREY P, GOH L, COOPER D
Objective: to determine whether more intensive antiretroviral therapy affects the rate of viral decay and immunological recovery in patients treated prior to HIV seroconversion.
Methods: Patients presenting with symptomatic PHI and <4 Western Blot bands treated with either a 3 drug combination (ZDV+ 3TC + indinavir or nelfinavir) were compared to similar PHI patients treated with a 4 drug combination (ZDV + 3TC + abacavir + amprenavir). Plasma viral load, and T-lymphocyte markers (CD4, CD8, CD38, HLA-DR, CD28, and RO) were assessed monthly over a 1 year period. Change in these variables from baseline to week 48 was analysed for all patients who completed a year on treatment.
Results: The median log baseline viral loads were 6.3 for the 3 drug group (N=17) and 6.1 for the 4 drug group (N=18). 1st and 2nd stage decay rates were not significantly different between groups, with a median VL decrease from baseline of -4.6 and -4.4 logs by 48 weeks respectively (p>0.05). Median CD4 cell numbers at week 48 were also similar (714 vs 594; p=0.2), as was the CD4 activation marker CD38+HLA-DR+. However, total CD8 cell numbers at week 48 (814 vs 535), as well as the CD8 subsets CD38+ (411 vs 129), CD38+HLA-DR+ (106 vs 59), CD28- (393 vs 236) and CD45RO+ (255 vs 134) cell numbers were all significantly higher (p<0.05 for each population) in the 3 drug group compared to the 4 drug group, respectively. This difference was most marked for CD8+CD38+ subset.
Conclusions: Although viral load decay rates did not differ with the use of more ARV agents in very early PHI disease in this non-randomised study, immunological markers of T-cell activation were significanlty reduced, suggesting greater suppression of HIV replication, below the currently detectable levels in plasma.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
61
Suggested Citation
"SMITHD, et al.
GREATER SUPPRESSION OF CD8 ACTIVATION WITH 4 VS 3 DRUGS IN EARLY STAGES OF PRIMARY HIV INFECTION (PHI) DESPITE SIMILAR PLASMA VIROLOGICAL DECAY RATES..
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
61"
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