Lower HAART Adherence Observed Prior to Viral Load "Blips" Some HIV positive patients starting combination antiretroviral therapy achieve full virological suppression (< 50copies/mL), but nevertheless fail to attain a CD4 cell count above 200 cells/mm3. Canadian researchers conducted a study to determine if such patients are at greater risk of clinical events. Results were presented at the 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, taking place this week in San Francisco. The researchers studied a British Columbia cohort of antiretroviral-naive HIV positive patients who initiated triple combination antiretroviral therapy between August 1996 and September 2003. The 299 analyzed subjects had baseline CD4 counts below 200 cells/mm3 and viral loads above 50 copies/mL, and had achieved 2 sequential viral load measurements below 50 copies/mL within the first year of starting combination therapy. The primary endpoint was non-accidental death or an AIDS-defining event. Subjects were followed until death, progression to AIDS, viral load above 50 copies/mL, or September 2004. The predictor of interest was whether the CD4 count 1 year after starting HAART was below or above 200 cells/mm3. Results
Conclusion According to the researchers, "HIV-infected patients on combination antiretroviral therapy who achieve complete viral suppression but fail to attain CD4 [counts] greater than or equal to 200 cells/mm3 have increased clinical events within the first year of combination antiretroviral therapy." If the CD4 count did not rise to 200 cell/mm3 or higher after 1 year, they added, "there remained an increased risk of clinical events thereafter." Univ. of Toronto, Canada; British Columbia Center. for Excellence in HIV/AIDS, Vancouver, Canada. 09/29/06 Reference
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299 patients were followed for a median of 21 months (IQR 13-35).| |
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