When Added to a Stable Treatment Regimen, Tenofovir Has Limited Effect on HIV RNA Levels and No Significant Impact on CD4 Counts

The aim of the present study was to explore the treatment effect of tenofovir (Viread) as implemented in clinical practice. Data are presented on 34 patients.

Eleven patients had tenofovir added to a stable antiretroviral treatment (ART) and 23 patients had drugs other than tenofovir. CD4 counts, HIV RNA levels and genotypic resistance were determined at baseline and after 3 and 6 months.

After initiation of tenofovir treatment, a mean decrease in HIV-RNA for all 34 patients was observed (-0.43 log1o copies/ml (+/- 1.22) and -0.49 log10 copies/ml (+/- 1.36) after 3 and 6 months, respectively, (p = 0.045)).

However, the effect of tenofovir on HIV RNA in the group of patients who had tenofovir added to a stable ART was limited, and the decrease in HIV RNA was significantly higher in patients who had drugs other than tenofovir changed as well (p = 0.004 and p = 0.03 after 3 and 6 months, respectively).

After initiation of tenofovir treatment, no significant increases in CD4 count were observed. All new NRTI-associated mutations could be explained by the background treatment.

In conclusion, the authors write, “We observed a significant decrease in HIV RNA only when tenofovir was prescribed, in conjunction with other antiretroviral drugs, to patients on a failing HAART.

Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark.

06/23/04