Rates and determinants of virologic and immunological response to HAART resumption after treatment interruption in HIV-1 clinical practice.
Details
Serval ID
serval:BIB_1E319FD32C09
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Rates and determinants of virologic and immunological response to HAART resumption after treatment interruption in HIV-1 clinical practice.
Journal
Journal of Acquired Immune Deficiency Syndromes
Working group(s)
CASCADE Collaboration
Contributor(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 HC., de Luca A., Fisher M., Goujard C., Muga R., Kaldor J., Kelleher T., Gelgor L., Ramacciotti T., Cooper D., Smith D., Gill J., Jørgensen LB., Nielsen C., Pedersen C., Lutsar I., 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., Garcia de Olalla P., 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
1525-4135 (Print)
ISSN-L
1525-4135
Publication state
Published
Issued date
12/2008
Peer-reviewed
Oui
Volume
49
Number
5
Pages
492-498
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
OBJECTIVE: To describe CD4 and HIV RNA changes during treatment resumption (TR) after treatment interruption (TI) compared with response to first highly active antiretroviral therapy (HAART) and to investigate predictors.
METHODS: Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA<500 copies per milliliter and subsequent rebound and factors associated with these outcomes.
RESULTS: Of 281 persons treated for median 18.4 months before interrupting, 259 resumed HAART. CD4 increases in the first 3 months on HAART were similar pre-TI and post-TI but after 3 months were significantly higher during pre-TI HAART, with median +106 and +172 cells per microliter at 3 and 18 months, respectively, during initial HAART compared with +99 and +142 cells per microliter during post-TI HAART, respectively. Subjects with lower CD4 counts at TI, aged older than 40 years, and those resuming the same HAART as their pre-TI regimen had lower CD4 increases during the first 3 months of TR. The majority (86%) of individuals reinitiating therapy achieved HIV RNA<500 copies per milliliter.
CONCLUSIONS: Immune reconstitution after TI is generally poorer than after first HAART, particularly for patients aged older than 40 years at TI and those with poorer immunological responses to pre-TI HAART. Reinitiation of the same HAART regimen as pre-TI also seems to have unfavorable outcomes.
METHODS: Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA<500 copies per milliliter and subsequent rebound and factors associated with these outcomes.
RESULTS: Of 281 persons treated for median 18.4 months before interrupting, 259 resumed HAART. CD4 increases in the first 3 months on HAART were similar pre-TI and post-TI but after 3 months were significantly higher during pre-TI HAART, with median +106 and +172 cells per microliter at 3 and 18 months, respectively, during initial HAART compared with +99 and +142 cells per microliter during post-TI HAART, respectively. Subjects with lower CD4 counts at TI, aged older than 40 years, and those resuming the same HAART as their pre-TI regimen had lower CD4 increases during the first 3 months of TR. The majority (86%) of individuals reinitiating therapy achieved HIV RNA<500 copies per milliliter.
CONCLUSIONS: Immune reconstitution after TI is generally poorer than after first HAART, particularly for patients aged older than 40 years at TI and those with poorer immunological responses to pre-TI HAART. Reinitiation of the same HAART regimen as pre-TI also seems to have unfavorable outcomes.
Keywords
Adolescent, Adult, Anti-HIV Agents/administration & dosage, Anti-HIV Agents/therapeutic use, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Drug Administration Schedule, Female, HIV Infections/drug therapy, HIV Infections/immunology, HIV-1, Humans, Male, Young Adult
Pubmed
Web of science
Create date
05/03/2009 16:12
Last modification date
20/08/2019 12:54
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