title: Plasma HIV load and proviral DNA decreases after two standard antiretroviral regimens in HIV-positive patients naïve to antiretrovirals.
abstract: (i) To compare early decrease of HIV plasma viral load (pVL) after two standard combinations of highly active antiretroviral therapy (HAART). (ii) To evaluate variations of proviral HIV-DNA load on conditions of sustained pVL undetectability. Two different sub-studies of a multicentre prospective randomized controlled trial which compared two first-line HAART (i.e., zidovudine+lamivudine+lopinavir/ritonavir versus tenofovir+lamivudine+ efavirenz). Only patients enrolled at the coordinating centre (University of Brescia) were included in the two sub-studies. In the first sub-study, we calculated pVL decrease with respect to baseline at any of the following time-points: days 1, 3, 7, 14 and 28. Decreases of the pVL were compared between the two treatment groups. In the second sub-study, we analyzed variation of proviral HIV-DNA load in CD4+ T-cells from baseline to week 52 only in patients who maintained the same treatment regimen and had sustained undetectable pVL. In either studies, linear regression analysis was used to investigate what factors could influence variations of pVL and of proviral HIV-DNA load. (i) 64 patients were studied. A significant decrease of pVL was found from day 3 on, without statistically significant differences between the two study groups. However, after adjusting for possible confounders, tenofovir+lamivudine+efavirenz resulted to be associated with greater pVL decreases. (ii) 45 patients were studied. Mean proviral HIV-DNA load decreased from 1,610 (95%CI: 879-2,341) to 896 (95% CI 499-1,293) copies/10(6) cells (P=0.05). Linear regression analysis showed that the decrease of proviral DNA load during follow-up was independently and inversely correlated with age. Further studies are needed to compare pVL decay between antiretroviral regimens and assess whether proviral HIV-DNA load is a surrogate marker of treatment effectiveness.
authors.affiliation: Institute for Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. torti.carlo@libero.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Torti
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Quiros-Roldan
authors.forename: Giuliana
authors.initials: G
authors.lastname: Cologni
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.forename: Francesca
authors.initials: F
authors.lastname: Ceresoli
authors.forename: Marcello
authors.initials: M
authors.lastname: Pinti
authors.forename: Milena
authors.initials: M
authors.lastname: Nasi
authors.forename: Andrea
authors.initials: A
authors.lastname: Cossarizza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lapadula
authors.forename: Silvia
authors.initials: S
authors.lastname: Costarelli
authors.forename: Nino
authors.initials: N
authors.lastname: Manca
authors.forename: Franco
authors.initials: F
authors.lastname: Gargiulo
authors.forename: Michele
authors.initials: M
authors.lastname: Magoni
authors.forename: Giampiero
authors.initials: G
authors.lastname: Carosi
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000328:Adult; D000480:Alkynes; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D048588:Benzoxazines / Q000008:administration & dosage; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000821:virology*; D003521:Cyclopropanes; D004279:DNA, Viral / Q000097:blood / Q000187:drug effects*; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000145:classification; D000068698:Tenofovir; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D015415:Biomarkers; D003521:Cyclopropanes; D004279:DNA, Viral; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000068698:Tenofovir; D000225:Adenine; C098320:efavirenz