|
Extended
Treatment Interruption in HIV Patients with Long-term Suppression
of HIV RNA
Treatment
interruption (TI) in patients with HIV infection remains controversial.
In this study researchers evaluated extended treatment interruption
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 <500 HIV-1 RNA
copies/mL for at least 6 months, and an interruption in therapy
of  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.
Results
At
initiation of TI, the median CD4 count was 799 cells/microliter.
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
pre-suppression CD4 count  350 cells/microliter.
Patients
who reinitiated therapy had shorter TI duration, pre-suppression
CD4 count 350 cells/microliter,
previous AIDS diagnosis and lipodystrophy.
No
patients developed adverse or AIDS-defining
events during TI.
Conclusions
“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,” according
to the study authors.
02/09/05
Reference
C J Achenbach and others. Extended antiretroviral treatment interruption
in HIV-infected patients with long-term suppression of plasma
HIV RNA. HIV Medicine 6(1): 7-12. January 2005.
Link to Index of All HIV and AIDS
Articles by Topic
|
