Treatment of primary HIV-1 infection with nonnucleoside reverse transcriptase inhibitor-based therapy is effective and well tolerated.
OBJECTIVE
Highly active antiretroviral therapy (HAART) has been advocated for the management of primary HIV-1 infection. We investigated the use of a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen in this setting.


METHODS
Twenty-one antiretroviral-naïve individuals with early HIV-1 disease were treated with a combination of efavirenz and Combivir (GlaxoSmithKline, Uxbridge, Middlesex, UK). They were evaluated for immune and lymphocyte function by standard immunological assays.


RESULTS
The median time to an undetectable HIV-1 viral load was 12 weeks (range 4-36 weeks). CD4 and CD16/56 counts increased during treatment and CD8 counts decreased minimally. The main side-effects observed were transient sleep disturbances (five patients). In addition, we observed a decrease in lymphocyte activation as assessed by CD38 surface expression.


CONCLUSIONS
This study demonstrates that primary HIV-1 infection can be treated with NNRTI-based HAART.
Portsmouth
S
S
Chelsea and Westminster Hospital, London, UK. simonportsmouth@hotmail.com
Imami
N
N
Pires
A
A
Stebbing
J
J
Hand
J
J
Nelson
M
M
Gotch
F
F
Gazzard
B G
BG
D000328:Adult; D000480:Alkynes; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D048588:Benzoxazines; D016516:CD4-CD8 Ratio; D003521:Cyclopropanes; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008213:Lymphocyte Activation; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D010078:Oxazines / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use*
D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D004338:Drug Combinations; D010078:Oxazines; D018894:Reverse Transcriptase Inhibitors; C109078:lamivudine, zidovudine drug combination; D019259:Lamivudine; D015215:Zidovudine; C098320:efavirenz