Delaying a treatment switch in antiretroviral-treated HIV type 1-infected patients with detectable drug-resistant viremia does not have a profound effect on immune parameters: AIDS Clinical Trials Group Study A5115.
Some patients are unable to achieve and maintain an undetectable plasma HIV-1 RNA level with combination antiretroviral therapy (ART) and are therefore maintained on a partially suppressive regimen. To determine the immune consequences of continuing ART despite persistent viremia, we randomized 47 ART-treated individuals with low to moderate plasma HIV-1 RNA levels (200-9999 copies/ml) to either an immediate switch in therapy or a delayed switch (when plasma HIV-1 RNA became > or =10,000 copies/ml). After 48 weeks of follow-up, naive and memory CD4+ T cell percents were comparable in the two groups. The proportion of subjects with a lymphocyte proliferative response to Candida, Mycobacterium avium-intracellulare complex, or HIV-gag was also not significantly different at week 48. Delaying a treatment switch in patients with partial virologic suppression and stable CD4+ T cells does not have profound effects on immune parameters.
Tenorio
Allan R
AR
Department of Medicine, Rush Medical College, Rush University Medical Center, 600 S. Paulina Street, Chicago, IL 60612, USA. allan_s_tenorio@rush.edu
Jiang
Hongyu
H
Zheng
Yu
Y
Bastow
Barbara
B
Kuritzkes
Daniel R
DR
Bartlett
John A
JA
Deeks
Steven G
SG
Landay
Alan L
AL
Riddler
Sharon A
SA
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000276:immunology; D049109:Cell Proliferation; D024882:Drug Resistance, Viral; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D015269:Mycobacterium avium Complex / Q000276:immunology; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D044966:Anti-Retroviral Agents; D012367:RNA, Viral