The effect of antiretroviral treatment of different durations in primary HIV infection.

Détails

ID Serval
serval:BIB_4F7C7DEB9B11
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The effect of antiretroviral treatment of different durations in primary HIV infection.
Périodique
Aids
Auteur⸱e⸱s
Pantazis N., Touloumi G., Vanhems P., Gill J., Bucher H.C., Porter K.
Collaborateur⸱rice⸱s
CASCADE Collaboration
Contributeur⸱rice⸱s
Del Amo J., Meyer L., Bucher HC., Chêne G., Pillay D., Prins M., Rosinska M., Sabin C., Touloumi G., Porter K., Lodi S., Walker S., Babiker A., Darbyshire J., Bucher H., de Luca A., Fisher M., Muga R., Kaldor J., Kelleher T., Ramacciotti T., Gelgor L., Cooper D., Smith D., Gill J., Jørgensen LB., Nielsen C., Pedersen C., Lutsar I., Chêne G., Dabis F., Thiebaut R., Masquelier B., Costagliola D., Guiguet M., Vanhems P., Meyer L., Boufassa F., Hamouda O., Kucherer C., Touloumi G., Pantazis N., Hatzakis A., Paraskevis D., Karafoulidou A., Rezza G., Dorrucci M., Longo B., Balotta C., Prins M., van Asten L., van der Bij A., Geskus R., Coutinho R., Sannes M., Brubakk O., Eskild A., Bruun JN., Rosinska M., Camacho R., Smolskaya T., Muga R., de Olalla PG. , Del Amo J., del Romero J., Pérez-Hoyos S., Aguado IH., Bucher HC., Rickenbach M., Francioli P., Malyuta R., Brettle R., Delpech V., Lattimore S., Murphy G., Parry J., Gill N., Sabin C., Lee C., Porter K., Johnson A., Phillips A., Babiker A., Darbyshire J., Delpech V., Pillay D., Jaffe H.
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Statut éditorial
Publié
Date de publication
11/2008
Peer-reviewed
Oui
Volume
22
Numéro
18
Pages
2441-2450
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
OBJECTIVES: To compare immunological, virological and clinical outcomes in persons initiating combination antiretroviral therapy (cART of different durations within 6 months of seroconversion (early treated) with those who deferred therapy (deferred group).
DESIGN: CD4 cell and HIV-RNA measurements for 'early treated' individuals following treatment cessation were compared with the corresponding ART-free period for the 'deferred' group using piecewise linear mixed models. Individuals identified during primary HIV infection were included if they seroconverted from 1st January 1996 and were at least 15 years of age at seroconversion. Those with at least 2 CD4 less than 350 cells/microl or AIDS within the first 6 months following seroconversion were excluded.
RESULTS: Of 348 'early treated' patients, 147 stopped cART following treatment for at least 6 (n = 38), more than 6-12 (n = 40) or more than 12 months (n = 69). CD4 cell loss was steeper for the first 6 months following cART cessation, but subsequent loss rate was similar to the 'deferred' group (n = 675, P = 0.26). Although those treated for more than 12 months appeared to maintain higher CD4 cell counts following cART cessation, those treated for 12 months or less had CD4 cell counts 6 months after cessation comparable to those in the 'deferred' group. There was no difference in HIV-RNA set points between the 'early' and 'deferred' groups (P = 0.57). AIDS rates were similar but death rates, mainly due to non-AIDS causes, were higher in the 'deferred' group (P = 0.05).
CONCLUSION: Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months. Its long-term effects remain inconclusive and need further investigation.
Mots-clé
Adolescent, Adult, Age Factors, Anti-Retroviral Agents/therapeutic use, CD4 Lymphocyte Count/methods, Disease Progression, Drug Administration Schedule, Drug Therapy, Combination, Female, HIV Infections/drug therapy, HIV Infections/immunology, HIV-1/immunology, Humans, Male, RNA, Viral/metabolism, Treatment Outcome, Viral Load, Young Adult
Pubmed
Web of science
Création de la notice
05/03/2009 16:09
Dernière modification de la notice
20/08/2019 14:05
Données d'usage