title: Baseline cellular HIV DNA load predicts HIV DNA decline and residual HIV plasma levels during effective antiretroviral therapy.
abstract: Cellular human immunodeficiency virus type 1 (HIV-1) DNA may be considered a marker of disease progression with significant predictive power, but published data on its correlation with plasma HIV RNA levels and CD4 counts in acute and chronic patients are not conclusive. We evaluated a cohort of 180 patients naïve for antiretroviral therapy before the beginning of treatment and after a virological response in order to define the indicators correlated with HIV DNA load decrease until undetectability. The following variables were evaluated as continuous variables: age, CD4 cell count and log(10) HIV DNA level at baseline and follow-up, and baseline log(10) HIV RNA level. Primary HIV infection at the start of therapy, an HIV RNA level at follow-up of <2.5 copies/ml, origin, gender, and transmission risk were evaluated as binary variables. The decline of HIV DNA values during effective therapy was directly related to baseline HIV DNA and HIV RNA values, to an increase in the number of CD4 cells, and to the achievement of an HIV RNA load of <2.5 copies/ml. An undetectable cellular HIV DNA load was achieved by 21.6% of patients at the follow-up time point and correlated significantly with lower baseline cellular HIV DNA values and with being in the primary stage of infection when therapy started. In conclusion, early treatment facilitated the achievement of undetectable levels of plasma viremia and cellular HIV DNA and a better recovery of CD4 lymphocytes. HIV DNA levels before and during highly active antiretroviral therapy may be used as a new tool for monitoring treatment efficacy.
authors.affiliation: Department of Histology, Microbiology and Medical Biotechnology, University of Padova, Padua, Italy. saverio.parisi@unipd.it
authors.forename: Saverio Giuseppe
authors.initials: SG
authors.lastname: Parisi
authors.forename: Samantha
authors.initials: S
authors.lastname: Andreis
authors.forename: Carlo
authors.initials: C
authors.lastname: Mengoli
authors.forename: Renzo
authors.initials: R
authors.lastname: Scaggiante
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferretto
authors.forename: Vinicio
authors.initials: V
authors.lastname: Manfrin
authors.forename: Mario
authors.initials: M
authors.lastname: Cruciani
authors.forename: Mario
authors.initials: M
authors.lastname: Giobbia
authors.forename: Caterina
authors.initials: C
authors.lastname: Boldrin
authors.forename: Monica
authors.initials: M
authors.lastname: Basso
authors.forename: Massimo
authors.initials: M
authors.lastname: Andreoni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Palù
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D001769:Blood / Q000821:virology*; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis* / Q000235:genetics; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000821:virology; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral