Predictors of plasma human immunodeficiency virus type 1 RNA control after discontinuation of highly active antiretroviral therapy initiated at acute infection combined with structured treatment interruptions and immune-based therapies

J Infect Dis. 2003 Nov 15;188(10):1426-32. doi: 10.1086/379251. Epub 2003 Oct 27.

Abstract

Thirty patients with acute human immunodeficiency virus (HIV) type 1 infection received a combination of 3 antiretroviral drugs (n=15) or 4 antiretroviral drugs plus hydroxyurea and interleukin-2 (n=15) for 24 months, followed by 1-3 structured therapeutic interruptions (STIs). Viral control, defined as maintaining plasma viremia <5000 copies/mL without therapy, was achieved in 14 cases. Lymphocyte subsets, plasma HIV-1 RNA loads, proviral DNA loads in peripheral blood mononuclear cells (PBMCs), residual HIV-1 RNA loads in PBMCs and in lymph node cells, and anti-p24 lymphoproliferative response were measured. In the multivariate analysis, proviral DNA loads in PBMCs and anti-p24 lymphoproliferative response assessed at 24 months were independently correlated with viral control after STI. These results enabled us to define a subgroup of patients for whom safe discontinuation of therapy initiated at acute infection was suitable and contributed to ascertaining priority for biological parameter assessment in future clinical trials.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • DNA, Viral / blood
  • Drug Administration Schedule
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / virology*
  • HIV-1 / genetics*
  • Humans
  • Hydroxyurea / administration & dosage
  • Hydroxyurea / therapeutic use
  • Interleukin-2 / administration & dosage
  • Interleukin-2 / therapeutic use
  • Male
  • Multivariate Analysis
  • Nucleic Acid Synthesis Inhibitors / administration & dosage*
  • Nucleic Acid Synthesis Inhibitors / therapeutic use
  • Pilot Projects
  • Proportional Hazards Models
  • Proviruses / growth & development
  • Proviruses / immunology
  • RNA, Viral / blood
  • Reverse Transcriptase Inhibitors / administration & dosage*
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Viremia
  • Virus Replication

Substances

  • DNA, Viral
  • Interleukin-2
  • Nucleic Acid Synthesis Inhibitors
  • RNA, Viral
  • Reverse Transcriptase Inhibitors
  • Hydroxyurea