Early and prolonged decrease of viremia in HIV-1-infected patients treated with didanosine.
Fourteen patients previously treated with zidovudine were monitored for laboratory parameters and clinical events during 1 year after introduction of didanosine (ddI) monotherapy. Proviral human immunodeficiency virus type 1 (HIV-1) copy numbers (cell-associated DNA) and concentration of free virions (viremia) were determined using a semiquantitative polymerase chain reaction (PCR). High levels of circulating virus were detected in all patients (range, 17 to 5,934 x 10(3)/ml of serum). Within 4 weeks of therapy, a decrease of viremia (60 to 98%) was observed in nine patients. After 1 year of treatment, eight of these nine patients still had decreased viremia when proviral HIV DNA was decreased or stable, and CD4+ lymphocytes were stable or higher in seven of these eight patients. Antiviral effect was more pronounced in the six patients with CD4+ > 100/mm3 at entry, five of them belonging to the subgroup of the seven responding patients as compared to two of eight patients with CD4+ < 100/mm3. Clinical events in this small group were not statistically correlated with virologic parameters; however, responding patients had a tendency to stabilize or gain weight. This study suggests that measurement of viremia deserves further study as a marker of antiviral efficacy and might predict, even at 4 weeks, the beneficial potential of ddI.
Yerly
S
S
Central Laboratory of Virology, Geneva University Hospital, Switzerland.
Kaiser
L
L
Baumberger
C
C
Hirschel
B
B
Perrin
L H
LH
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D016049:Didanosine / Q000627:therapeutic use*; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics; D012367:RNA, Viral / Q000032:analysis; D014766:Viremia / Q000188:drug therapy* / Q000821:virology; D014771:Virion / Q000187:drug effects / Q000235:genetics; D015215:Zidovudine / Q000627:therapeutic use
D004279:DNA, Viral; D016655:HIV Core Protein p24; D012367:RNA, Viral; D015215:Zidovudine; D016049:Didanosine