Prolonged treatment interruption after immunologic response to highly active antiretroviral therapy.
Duration of treatment interruption (TI) was investigated in 105 human immunodeficiency virus-infected patients whose antiretroviral therapy was interrupted with the intention to resume therapy on the basis of clinical or laboratory indicators. In a mixed cohort study, 57% of patients had not resumed therapy at the time of writing (median TI duration, 114 weeks); the most recent analysis of this group revealed a mean CD4 cell count of 500 cells/mm3. Patients with lower CD4 cell counts at therapy initiation were more likely to resume therapy than were those with counts of >500 cells/mm3 (<200 cells/mm3 [relative hazard, 4.4]; and 200-350 cells/mm3 [relative hazard, 2.9]). Patients who met current United States Department of Health and Human Services criteria for starting therapy at the time of therapy initiation were 3 times more likely to resume therapy than were those who did not. Our results have implications for this TI strategy: there may be a subset of patients who can safely discontinue therapy for prolonged periods of time.
Tarwater
Patrick M
PM
University of Texas Health Science Center, School of Public Health, Houston, Texas, USA.
Parish
Michelle
M
Gallant
Joel E
JE
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000502:physiology*; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019562:Viral Load
D019380:Anti-HIV Agents