Extended antiretroviral treatment interruption in HIV‐infected patients with long‐term suppression of plasma HIV RNA
- 25 January 2005
- journal article
- research article
- Published by Wiley in HIV Medicine
- Vol. 6 (1), 7-12
- https://doi.org/10.1111/j.1468-1293.2005.00257.x
Abstract
Evaluation of extended treatment interruption (TI) in chronic HIV infection among patients successfully treated with antiretroviral therapy. An observational analysis of 25 patients in a prospectively followed cohort with chronic HIV infection, viral loads /=28 days duration was carried out. Follow up was divided into 3-month time periods for analysis. The effects of time period, stratification group and stratification group by time period interactions on CD4 counts were tested using a mixed model. Univariate comparisons among patient characteristics and responses were performed using Fisher's exact test or the Wilcoxon rank sum test. At initiation of TI, the median CD4 count was 799 cells/microL. TI duration was a median of 7.1 months. HIV RNA rebounded to a median maximum level of 75 000 copies/mL. Maximum viral rebound was significantly greater in patients who were male, had lipodystrophy and had zenith HIV RNA prior to TI of >/=50 000 copies/mL. Lower CD4 cell counts were observed during TI in patients with lipodystrophy, zenith HIV RNA >/=50 000 copies/mL, history of AIDS, HIV infection >/=5 years and presuppression CD4 count </=350 cells/muL. Patients who reinitiated therapy had shorter TI duration, presuppression CD4 count </=350 cells/microL, previous AIDS diagnosis and lipodystrophy. No patients developed adverse or AIDS-defining events during TI. Long-term TI resulted in greater immune deterioration in patients with high viral set points or low CD4 cell counts prior to initiation of suppressive antiretroviral therapy.Keywords
This publication has 16 references indexed in Scilit:
- The impact on health-related quality of life of treatment interruptions in HIV-1-infected patientsAIDS, 2003
- Immunological changes during treatment interruptionsAIDS, 2003
- Immunologic and Virologic Consequences of Temporary Antiretroviral Treatment Interruption in Clinical PracticeAIDS Research and Human Retroviruses, 2002
- Kinetics of CD4 cells after discontinuation of antiretroviral therapy in patients with virological failure and a CD4 cell count greater than 500 cells/μlAIDS, 2002
- Psychological impact of structured treatment interruptions in patients with prolonged undetectable HIV-1 viral loadsAIDS, 2001
- Changes in Human Immunodeficiency Virus Type 1 Populations after Treatment Interruption in Patients Failing Antiretroviral TherapyJournal of Virology, 2001
- Virologic and Immunologic Consequences of Discontinuing Combination Antiretroviral-Drug Therapy in HIV-Infected Patients with Detectable ViremiaNew England Journal of Medicine, 2001
- Natural History of Human Immunodeficiency Virus Type 1 Viremia after Seroconversion and Proximal to AIDS in a Large Cohort of Homosexual MenThe Journal of Infectious Diseases, 2000
- Structured treatment interruptions to control HIV-1 infectionThe Lancet, 2000
- Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus InfectionNew England Journal of Medicine, 1998