title: HIV-1-infected antiretroviral-treated patients with prolonged partial viral suppression: clinical, virologic, and immunologic course.
abstract: The long-term feasibility of a drug conservation strategy that allows low-level viral replication is unknown. We performed a retrospective study of treated HIV-infected patients with stable detectable viral replication (<10000 copies/mL [low-level viremia]) and compared their clinical, virologic and immunologic courses with those of treated patients with undetectable viremia and viremia (>or=10000 copies/mL [high-level viremia]). Viral reverse transcriptase and protease genotype and HIV-specific CD4 T-cell responses were determined using patient-derived samples. Clinical and immunologic benefits were maintained in patients with partial virologic suppression (<or=10000 copies/mL). Although low-level viral replication under drug pressure led to the accumulation of resistance mutations in most subjects' viruses, most subjects retained susceptibility to drugs in >or=2 classes of antiretroviral medications. HIV-specific CD4+ T-cell immunity was detected in most subjects with low-level and undetectable viremia and may have a role in controlling viremia in the setting of partial suppression.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. allan_s_tenorio@rush.edu
authors.forename: Allan R
authors.initials: AR
authors.lastname: Tenorio
authors.forename: Kimberly Y
authors.initials: KY
authors.lastname: Smith
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kuritzkes
authors.forename: Beverly E
authors.initials: BE
authors.lastname: Sha
authors.forename: Betty
authors.initials: B
authors.lastname: Donoval
authors.forename: Russell
authors.initials: R
authors.lastname: Young
authors.forename: Cheryl
authors.initials: C
authors.lastname: Jennings
authors.forename: James
authors.initials: J
authors.lastname: Bremer
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
authors.forename: Alan
authors.initials: A
authors.lastname: Landay
authors.forename: Harold A
authors.initials: HA
authors.lastname: Kessler
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008297:Male; D009154:Mutation; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D012189:Retrospective Studies; D019562:Viral Load; D014779:Virus Replication / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral