Improvements in HIV-RNA assays have made accurate detection of as few as 2 copies/ml possible. This study objective was the evaluation of ultrasensitive HIV-RNA quantitation (beneath current threshold: 50 copies/ml) in patients receiving different antiretroviral regimens. A cross-sectional, ultrasensitive measurement of HIV-RNA levels (detection limit: 2.5 HIV-RNA copies/ml) was performed in 154 HIV-1-infected patients receiving ARV therapy, all classed as full responders according to the 50 copies/ml cut-off. Patients were undergoing treatment with two nucleoside/nucleotide reverse transcriptase inhibitors (N/NtRTIs) plus nevirapine (NVP, n = 48), efavirenz (EFV, n = 57) or lopinavir/ritonavir (LPV/r, n = 49). Undetectable HIV-RNA (<2.5 copies/ml) occurred in 29/48 (60.4%), 24/57 (42.1%) and 14/49 (28.6%) NVP, EFV and LPV/r recipients, respectively. Mean virological-suppression (<50 copies/ml) duration was 28.6 months (median = 22, SD = 17.8), and only in LPV/r recipients length of suppression was associated with significantly lower HIV-RNA levels (P = 0.015). Mean nadir CD4+ cell count of 270 cells/mm(3) (median = 240, SD = 194.5) was significantly lower in the LPV/r arm (P<0.001). Nadir CD4+ level correlated with virological suppression but had opposite trends between NVP (positive) and LPV/r (negative; two tailed P = 0.01). Logistic regression analysis showed NVP was the only independent factor associated with virologic suppression. NVP has demonstrated a distinct virological advantage at subclinical viral loads, possibly due to its greater penetration in extra-vascular compartments, warranting further investigation in the context of persistent low-level viraemia in long-term HAART. J. Med. Virol. 81:400-405,2009. (C) 2009 Wiley-Liss, Inc.

Bonora, S., Nicastri, E., Calcagno, A., De Requena, D.g., D'Ettorre, G., Sarmati, L., et al. (2009). Ultrasensitive assessment of residual HIV viraemia in HAART-treated patients with persistently undetectable plasma HIV-RNA: A cross-sectional evaluation. JOURNAL OF MEDICAL VIROLOGY, 81(3), 400-405 [10.1002/jmv.21405].

Ultrasensitive assessment of residual HIV viraemia in HAART-treated patients with persistently undetectable plasma HIV-RNA: A cross-sectional evaluation

SARMATI, LOREDANA;ANDREONI, MASSIMO
2009-01-01

Abstract

Improvements in HIV-RNA assays have made accurate detection of as few as 2 copies/ml possible. This study objective was the evaluation of ultrasensitive HIV-RNA quantitation (beneath current threshold: 50 copies/ml) in patients receiving different antiretroviral regimens. A cross-sectional, ultrasensitive measurement of HIV-RNA levels (detection limit: 2.5 HIV-RNA copies/ml) was performed in 154 HIV-1-infected patients receiving ARV therapy, all classed as full responders according to the 50 copies/ml cut-off. Patients were undergoing treatment with two nucleoside/nucleotide reverse transcriptase inhibitors (N/NtRTIs) plus nevirapine (NVP, n = 48), efavirenz (EFV, n = 57) or lopinavir/ritonavir (LPV/r, n = 49). Undetectable HIV-RNA (<2.5 copies/ml) occurred in 29/48 (60.4%), 24/57 (42.1%) and 14/49 (28.6%) NVP, EFV and LPV/r recipients, respectively. Mean virological-suppression (<50 copies/ml) duration was 28.6 months (median = 22, SD = 17.8), and only in LPV/r recipients length of suppression was associated with significantly lower HIV-RNA levels (P = 0.015). Mean nadir CD4+ cell count of 270 cells/mm(3) (median = 240, SD = 194.5) was significantly lower in the LPV/r arm (P<0.001). Nadir CD4+ level correlated with virological suppression but had opposite trends between NVP (positive) and LPV/r (negative; two tailed P = 0.01). Logistic regression analysis showed NVP was the only independent factor associated with virologic suppression. NVP has demonstrated a distinct virological advantage at subclinical viral loads, possibly due to its greater penetration in extra-vascular compartments, warranting further investigation in the context of persistent low-level viraemia in long-term HAART. J. Med. Virol. 81:400-405,2009. (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
Efavirenz; Lopinavir; Nevirapine; Ultrasensitive HIV-RNA assay
Bonora, S., Nicastri, E., Calcagno, A., De Requena, D.g., D'Ettorre, G., Sarmati, L., et al. (2009). Ultrasensitive assessment of residual HIV viraemia in HAART-treated patients with persistently undetectable plasma HIV-RNA: A cross-sectional evaluation. JOURNAL OF MEDICAL VIROLOGY, 81(3), 400-405 [10.1002/jmv.21405].
Bonora, S; Nicastri, E; Calcagno, A; De Requena, Dg; D'Ettorre, G; Sarmati, L; Palmisano, L; Vullo, V; Di Perri, G; Andreoni, M
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/39205
Citazioni
  • ???jsp.display-item.citation.pmc??? 14
  • Scopus 54
  • ???jsp.display-item.citation.isi??? 54
social impact