title: Safety and factors predicting the duration of first and second treatment interruptions guided by CD4+ cell counts in patients with chronic HIV infection.
abstract: OBJECTIVE
  To evaluate the safety of treatment interruption (TI) guided by CD4+ count in HIV-infected patients followed-up prospectively.
  
  
  METHODS
  Patients on HAART with a CD4+ cell count >500 cells/mm3 discontinued therapy with instructions to start therapy again before their CD4+ count dropped below 200 cells/mm3.
  
  
  RESULTS
  We report data on 112 HIV-infected patients. The median follow-up after starting the first TI was 34.7 months (IQR: 23.1-43.8). The median duration of the first TI was 12 months (IQR: 5.2-25). In the multivariate analysis the factor which most strongly correlated with the duration of the first TI was the CD4+ cell count at the end of the TI. Among the 34 patients who had completed a second TI, the duration of the two periods of interruption was similar if the treatment was recommenced at the end of the first TI at a CD4+ count higher than the nadir count.
  
  
  CONCLUSIONS
  The strategy of TI is safe if the criteria for restarting therapy are applied correctly. The factor with the greatest influence on the duration of the first TI is the number of CD4+ cells at the end of the TI.
authors.affiliation: Division of Infectious Diseases, AUSL Rimini, Via Settembrini 2, 47900 Rimini, Italy. boschia@libero.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Boschi
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ortolani
authors.forename: Massimo
authors.initials: M
authors.lastname: Arlotti
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000494:pharmacology; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology* / Q000276:immunology; D004334:Drug Administration Schedule; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D015999:Multivariate Analysis; D013997:Time Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents