Hydroxyurea and didanosine long-term treatment prevents HIV breakthrough and normalizes immune parameters.
Hydroxyurea and didanosine treatment suppressed HIV replication for more than 2 years, in the absence of viral breakthrough, in chronically infected patients. The profile of viral load reduction was unusual for a two-drug combination, since a continuous gradual decrease in viremia persisted despite residual viral replication. The increase in CD4+ T cell counts was not robust. However, unlike those of patients treated by other therapies, CD4+ T lymphocytes were functionally competent against HIV, mediating a vigorous HIV-specific helper T cell response in half of these patients. In addition, the percentages of naive CD4+ and CD8+ T lymphocytes were not different from those in uninfected individuals. These results demonstrate that prolonged antiretroviral therapy with a simple, well-tolerated combination of two affordable drugs can lead to sustained control of HIV, normalization of immune parameters, and specific anti-HIV immune response.
Lori
F
F
Research Institute for Genetic and Human Therapy, Policlinico S. Matteo, Pavia, Italy.
Rosenberg
E
E
Lieberman
J
J
Foli
A
A
Maserati
R
R
Seminari
E
E
Alberici
F
F
Walker
B
B
Lisziewicz
J
J
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016049:Didanosine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D016130:Immunophenotyping; D008213:Lymphocyte Activation; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000276:immunology; D019562:Viral Load; D014779:Virus Replication / Q000187:drug effects
D019380:Anti-HIV Agents; D019384:Nucleic Acid Synthesis Inhibitors; D016049:Didanosine; D006918:Hydroxyurea