| It is safe to stop antiretroviral therapy in patients with preantiretroviral CD4 cell counts >250 cells/microL. | |
| | |
MedLine Citation:
|
PMID: 15483464 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To study clinical, immunologic, and virologic outcomes in patients who stop antiretroviral therapy (ART) with relatively preserved CD4 cell counts. DESIGN AND METHODS: Patients with a documented CD4 cell count >250 cells/microL who stopped ART for any reason for at least 5 weeks were studied. Relevant clinical and laboratory data were collected using a standardized data collection form. MAIN OUTCOME MEASURES: Patients were monitored for outcomes including Centers for Disease Control (CDC) category B or C events, time to restarting ART, and time to reaching a CD4 cell count of < or = 250 cells/microL. RESULTS: A total of 107 patients were included. The median time on ART was 45 months and median number of antiretroviral medications was 4. The median pre-ART CD4 cell count and HIV viral load were 463 cells/microL and 4.35 log copies/mL, respectively. The median CD4 cell at time of ART stop was 739 cell/microL. The slope of the CD4 decrease was 65 cells/mo in the first 2 months, which was greater than the subsequent decline of 8 cells/mo thereafter (P < 0.01). Similarly the median viral load increase was 2.54 log copies/mL in the first 2 months after stopping and was unchanged after that point. Two patients experienced the retroviral rebound syndrome after ART cessation but no CDC category B or C events were observed during 10 months of follow-up. The median time from stopping ART to reaching the combined endpoint of CD4 <250 or restarting ART was 8.9 months. In multivariate analysis, pre-ART CD4 cell count >250 was protective of reaching the combined endpoint (odds ratio = 0.156, P = 0.03). Other predictors of reaching the combined endpoint in multivariate analysis were older age and number of prior ART agents. Patients who restarted ART had a favorable virologic and immunologic response. CONCLUSIONS: Patients with relatively high CD4 cell counts prior to starting ART did well after stopping ART. Pre-ART CD4 cell count can be used to predict outcomes after ART cessation. |
| | |
Authors:
|
Daniel J Skiest; Patrick Morrow; Brady Allen; Judith McKinsey; Craig Crosby; Barbara Foster; R Doug Hardy |
Related Documents
:
|
8725664 - Sample preparation and in situ hybridization techniques for automated molecular cytogen... 1378064 - Keratinization of palatal mucosa beneath metal-based removable partial dentures. 12063064 - Genotoxicity of the kishon river, israel: the application of an in vitro cellular assay. 3063364 - A physical method for separating saccharomyces cerevisiae cells according to their ploidy. 7876094 - Differentiation- and protein kinase c-dependent regulation of alanine transport via sys... 23221614 - Vesicular monoamine transporter, type 2 (vmat2) expression as it compares to insulin an... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Journal of acquired immune deficiency syndromes (1999) Volume: 37 ISSN: 1525-4135 ISO Abbreviation: J. Acquir. Immune Defic. Syndr. Publication Date: 2004 Nov |
Date Detail:
|
Created Date: 2004-10-14 Completed Date: 2005-10-26 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 100892005 Medline TA: J Acquir Immune Defic Syndr Country: United States |
Other Details:
|
Languages: eng Pagination: 1351-7 Citation Subset: IM; X |
Affiliation:
|
University of Texas, Southwestern Medical Center, Dallas, TX 75390-9113, USA. skiest@utsouthwestern.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anti-HIV Agents / administration & dosage, therapeutic use* CD4 Lymphocyte Count* Drug Administration Schedule HIV / genetics, isolation & purification* Humans Multivariate Analysis Patient Selection RNA, Viral / blood Retrospective Studies Safety Viral Load* |
| Grant Support | |
ID/Acronym/Agency:
|
U01 AI046376/AI/NIAID NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Anti-HIV Agents; 0/RNA, Viral |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Patterns of resistance emerging in HIV-1 from antiretroviral-experienced patients undergoing intensi...
Next Document: Comparison of two indinavir/ritonavir regimens in the treatment of HIV-infected individuals.