Document Detail


The effect of antiretroviral treatment of different durations in primary HIV infection.
MedLine Citation:
PMID:  19005267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare immunological, virological and clinical outcomes in persons initiating combination antiretroviral therapy (cART of different durations within 6 months of seroconversion (early treated) with those who deferred therapy (deferred group).
DESIGN: CD4 cell and HIV-RNA measurements for 'early treated' individuals following treatment cessation were compared with the corresponding ART-free period for the 'deferred' group using piecewise linear mixed models. Individuals identified during primary HIV infection were included if they seroconverted from 1st January 1996 and were at least 15 years of age at seroconversion. Those with at least 2 CD4 less than 350 cells/microl or AIDS within the first 6 months following seroconversion were excluded.
RESULTS: Of 348 'early treated' patients, 147 stopped cART following treatment for at least 6 (n = 38), more than 6-12 (n = 40) or more than 12 months (n = 69). CD4 cell loss was steeper for the first 6 months following cART cessation, but subsequent loss rate was similar to the 'deferred' group (n = 675, P = 0.26). Although those treated for more than 12 months appeared to maintain higher CD4 cell counts following cART cessation, those treated for 12 months or less had CD4 cell counts 6 months after cessation comparable to those in the 'deferred' group. There was no difference in HIV-RNA set points between the 'early' and 'deferred' groups (P = 0.57). AIDS rates were similar but death rates, mainly due to non-AIDS causes, were higher in the 'deferred' group (P = 0.05).
CONCLUSION: Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months. Its long-term effects remain inconclusive and need further investigation.
Authors:
Nikos Pantazis; Giota Touloumi; Philippe Vanhems; John Gill; Heiner C Bucher; Kholoud Porter;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  22     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-13     Completed Date:  2009-02-20     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  2441-50     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Anti-Retroviral Agents / therapeutic use*
CD4 Lymphocyte Count / methods
Disease Progression
Drug Administration Schedule
Drug Therapy, Combination
Female
HIV Infections / drug therapy*,  immunology,  virology
HIV-1 / immunology*
Humans
Male
RNA, Viral / metabolism*
Treatment Outcome
Viral Load
Young Adult
Grant Support
ID/Acronym/Agency:
MC_U122886351//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/RNA, Viral
Investigator
Investigator/Affiliation:
Julia Del Amo / ; Laurence Meyer / ; Heiner C Bucher / ; Geneviève Chêne / ; Deenan Pillay / ; Maria Prins / ; Magda Rosinska / ; Caroline Sabin / ; Giota Touloumi / ; Kholoud Porter / ; Sara Lodi / ; Sarah Walker / ; Abdel Babiker / ; Janet Darbyshire / ; Heiner Bucher / ; Andrea de Luca / ; Martin Fisher / ; Roberto Muga / ; John Kaldor / ; Tony Kelleher / ; Tim Ramacciotti / ; Linda Gelgor / ; David Cooper / ; Don Smith / ; John Gill / ; Louise Bruun Jørgensen / ; Claus Nielsen / ; Court Pedersen / ; Irja Lutsar / ; Geneviève Chêne / ; Francois Dabis / ; Rodolphe Thiebaut / ; Bernard Masquelier / ; Dominique Costagliola / ; Marguerite Guiguet / ; Philippe Vanhems / ; Laurence Meyer / ; Faroudy Boufassa / ; Osamah Hamouda / ; Claudia Kucherer / ; Giota Touloumi / ; Nikos Pantazis / ; Angelos Hatzakis / ; Dimitrios Paraskevis / ; Anastasia Karafoulidou / ; Giovanni Rezza / ; Maria Dorrucci / ; Benedetta Longo / ; Claudia Balotta / ; Maria Prins / ; Liselotte van Asten / ; Akke van der Bij / ; Ronald Geskus / ; Roel Coutinho / ; Mette Sannes / ; Oddbjorn Brubakk / ; Anne Eskild / ; Johan N Bruun / ; Magdalena Rosinska / ; Ricardo Camacho / ; Tatyana Smolskaya / ; Roberto Muga / ; Patricia Garcia de Olalla / ; Julia Del Amo / ; Jorge del Romero / ; Santiago Pérez-Hoyos / ; Ildefonso Hernandez Aguado / ; Heiner C Bucher / ; Martin Rickenbach / ; Patrick Francioli / ; Ruslan Malyuta / ; Ray Brettle / ; Valerie Delpech / ; Sam Lattimore / ; Gary Murphy / ; John Parry / ; Noel Gill / ; Caroline Sabin / ; Christine Lee / ; Kholoud Porter / ; Anne Johnson / ; Andrew Phillips / ; Abdel Babiker / ; Janet Darbyshire / ; Valerie Delpech / ; Deenan Pillay / ; Harold Jaffe /

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