Aim of the study was to determine predictors of the duration of antiretroviral treatment interruption in patients infected with HIV. This pilot prospective, open-label, multicenter trial comprised 62 HIV-seropositive subjects who decided voluntarily to interrupt therapy after two or more years of successful HAART. The primary end-point was the time to patients being free of therapy before reaching a CD4+ cell count <= 350/mu l. Fifteen of 62 patients remained in treatment interruption for more than 180 days. Patients restarting therapy had higher HIV-DNA levels (P = 0.05), were treated more frequently with NNRTI-drugs (P = 0.02), had a shorter period of HAART (P = 0.046), and lower CD4+ cell counts after day 14 of interruption of treatment (P = 0.04). Multivariate regression analysis showed that less than 323 baseline proviral HIV-DNA Cp/10(6) PBMCs and more than 564 CD4 cells/mu l at day 14 after interruption were associated independently with a reduced risk of restarting treatment (P = 0.041 and P = 0.012, respectively). A score based on CD4+ cell counts at nadir, at baseline, at week 2 of treatment interruption, and on baseline HIV-DNA values can identify patients with a prolonged period free safely of treatment. J. Med. Virol. 81:481-487, 2009. (C) 2009 Wiley-Liss, Inc.

Sarmati, L., Andreoni, C., Nicastri, E., Tommasi, C., Buonomini, A., D'Ettorre, G., et al. (2009). Prognostic factors of long-term CD4+ count-guided interruption of antiretroviral treatment. JOURNAL OF MEDICAL VIROLOGY, 81(3), 481-487 [10.1002/jmv.21424].

Prognostic factors of long-term CD4+ count-guided interruption of antiretroviral treatment

SARMATI, LOREDANA;MONTANO, MARCO;VOLPI, ANTONIO;ANDREONI, MASSIMO
2009-01-01

Abstract

Aim of the study was to determine predictors of the duration of antiretroviral treatment interruption in patients infected with HIV. This pilot prospective, open-label, multicenter trial comprised 62 HIV-seropositive subjects who decided voluntarily to interrupt therapy after two or more years of successful HAART. The primary end-point was the time to patients being free of therapy before reaching a CD4+ cell count <= 350/mu l. Fifteen of 62 patients remained in treatment interruption for more than 180 days. Patients restarting therapy had higher HIV-DNA levels (P = 0.05), were treated more frequently with NNRTI-drugs (P = 0.02), had a shorter period of HAART (P = 0.046), and lower CD4+ cell counts after day 14 of interruption of treatment (P = 0.04). Multivariate regression analysis showed that less than 323 baseline proviral HIV-DNA Cp/10(6) PBMCs and more than 564 CD4 cells/mu l at day 14 after interruption were associated independently with a reduced risk of restarting treatment (P = 0.041 and P = 0.012, respectively). A score based on CD4+ cell counts at nadir, at baseline, at week 2 of treatment interruption, and on baseline HIV-DNA values can identify patients with a prolonged period free safely of treatment. J. Med. Virol. 81:481-487, 2009. (C) 2009 Wiley-Liss, Inc.
2009
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/17 - MALATTIE INFETTIVE
English
Con Impact Factor ISI
proteinase inhibitor; RNA directed DNA polymerase inhibitor; virus DNA; adult; article; CD4 lymphocyte count; controlled study; female; highly active antiretroviral therapy; human; Human immunodeficiency virus 1 infection; major clinical study; male; prognosis; scoring system; survival rate; treatment duration; blood; CD4+ T lymphocyte; clinical trial; Human immunodeficiency virus infection; immunology; methodology; middle aged; multicenter study; prospective study; time; treatment outcome; treatment withdrawal; Adult; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; DNA, Viral; Female; HIV Infections; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Time Factors; Treatment Outcome; Withholding Treatment
Sarmati, L., Andreoni, C., Nicastri, E., Tommasi, C., Buonomini, A., D'Ettorre, G., et al. (2009). Prognostic factors of long-term CD4+ count-guided interruption of antiretroviral treatment. JOURNAL OF MEDICAL VIROLOGY, 81(3), 481-487 [10.1002/jmv.21424].
Sarmati, L; Andreoni, C; Nicastri, E; Tommasi, C; Buonomini, A; D'Ettorre, G; Corpolongo, A; Dori, L; Montano, M; Volpi, A; Narciso, P; Vullo, V; Andr...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/39202
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