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Titolo:
Different outcomes in patients achieving complete or partial viral load suppression on antiretroviral therapy
Autore:
de Mendoza, C; Soriano, V; Perez-Olmeda, M; Rodes, B; Casas, E; Gonzalez-Lahoz, J;
Indirizzi:
Hosp Carlos III, Infect Dis Serv, Inst Salud Carlos III, Madrid, Spain Hosp Carlos III Madrid Spain Serv, Inst Salud Carlos III, Madrid, Spain Hosp Principe Asturias, Serv Internal Med, Madrid, Spain Hosp Principe Asturias Madrid Spain s, Serv Internal Med, Madrid, Spain
Titolo Testata:
JOURNAL OF HUMAN VIROLOGY
fascicolo: 6, volume: 2, anno: 1999,
pagine: 344 - 349
SICI:
1090-9508(199911/12)2:6<344:DOIPAC>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-INFECTED PATIENTS; TYPE-1 RNA; PLASMA; REPLICATION; ZIDOVUDINE; LAMIVUDINE; INDINAVIR; RESISTANCE; NEVIRAPINE;
Keywords:
HIV-1; viral load; HAART; drug-resistance; intensification; compartments;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Soriano, V C Rafael Calvo 7,2 A, Madrid 28010, Spain C Rafael Calvo 7,2 AMadrid Spain 28010 , Madrid 28010, Spain
Citazione:
C. de Mendoza et al., "Different outcomes in patients achieving complete or partial viral load suppression on antiretroviral therapy", J HUMAN VIR, 2(6), 1999, pp. 344-349

Abstract

Background: Potent combination antiretroviral therapy can reduce HIV plasma viral load (VL) to levels below the detection limit for as long as 2 years or more. A VL <500 RIV RNA copies/mL was until recently considered a reasonable therapeutic goal. However, lower levels seem necessary if VL rebounds and development of drug resistance are to be avoided. Patients and Methods: The clinical and virologic outcome at 1 year were prospectively examined in a group of 100 patients who began a triple combination antiretroviral therapy regimen consisting of stavudine (d4T), lamivudine (3TC), and indinavir (IDV). A modified ultrasensitive VL test with a detection limit of 40 copies/mL and a point mutation nested polymerase chain reaction (PCR) assay for detecting the codon 184 mutation conferring 3TC resistance were used for testing samples collected longitudinally from these individuals. Results: Overall, VL values <40 copies/mL were reached in 45% and 32% of patients at nadir and at 12 months, respectively. More than half (24 of 45 persons) who achieved a level <40 copies/mL at nadir remained with undetectable VL at 1 year, whereas this occurred in only one fourth (7 of 28 per sons) of those having levels of 40 to 500 copies/mL (P < .05). However, rebounds in VL to >500 copies/mL, at I year were seen at similar rates (26.6% and25%, respectively) in persons achieving either complete (<40 copies/mL) orpartial (40-500 copies/mL) VL suppression at nadir. In contrast, the codon184 mutation emerged more frequently at 1 year in patients whose VL remained between 40 and 500 copies/mL at nadir than in those who reached a level <40 copies/mL (30.7% versus 0%; P < .05). Conclusion: Plasma VL at nadir after beginning highly active antiretroviral therapy (HAART) predicts the 1-year outcome. The achievement of levels ofviremia <40 copies/mL are desirable during antiretroviral therapy if prolonged benefit is to be obtained. Because more than two thirds of persons with residual viremia do not show drug resistance, intensification strategies should be investigated fur those patients with a good virologic response but without complete suppressio during the first 6 months on HAART. (C) Lippincott Williams & Wilkins, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 02:25:26