title: First HAART in HIV-infected patients with high viral load: value of HIV RNA levels at 12 weeks to predict virologic outcome.
abstract: The aim of this study is to identify the role of incomplete suppression during the first months of highly active antiretroviral treatment (HAART) to predict virologic failure in patients with high levels of HIV replication. In a retrospective, longitudinal, and multicenter study, response to HAART was assessed in treatment-naive adults with HIV RNA >100 000 copies/mL, and factors predicting failure were analyzed through regression analyses. A total of 118 patients were included. Virologic failure occurred more often in patients with >500 copies/mL at week 12 (Cox regression: Exp (B) 3.22; P = .02). HIV RNA >500 copies/mL at week 12 predicted incomplete virologic response (odds ratio [OR] = 9.33; P = .002] but not viral rebound. Major antiretroviral resistant mutations were present in 11 of 14 patients. HIV RNA >500 copies/mL at week 12 of first HAART predicts incomplete virologic response in patients with high levels of replication at baseline. Most patients carried resistance mutations at the time of failure.
authors.affiliation: Wake Forest University Health Sciences, Winston Salem, NC 27157, USA.
authors.forename: David
authors.initials: D
authors.lastname: Townsend
authors.forename: Jesús
authors.initials: J
authors.lastname: Troya
authors.forename: Ivana
authors.initials: I
authors.lastname: Maida
authors.forename: Leticia
authors.initials: L
authors.lastname: Pérez-Saleme
authors.forename: Giovanni
authors.initials: G
authors.lastname: Satta
authors.forename: Aimee
authors.initials: A
authors.lastname: Wilkin
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
authors.forename: P Samuel
authors.initials: PS
authors.lastname: Pegram
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Mura
authors.forename: Marina
authors.initials: M
authors.lastname: Núñez
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000235:genetics*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012367:RNA, Viral / Q000097:blood*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D012367:RNA, Viral