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Extended antiretroviral treatment interruption in HIV-infected patients with long-term suppression of plasma HIV RNA.
HIV Med. 2005 Jan; 6(1):7-12.HM

Abstract

OBJECTIVES

Evaluation of extended treatment interruption (TI) in chronic HIV infection among patients successfully treated with antiretroviral therapy.

METHODS

An observational analysis of 25 patients in a prospectively followed cohort with chronic HIV infection, viral loads <500 HIV-1 RNA copies/mL for at least 6 months, and an interruption in therapy of >/=28 days duration was carried out. Follow up was divided into 3-month time periods for analysis. The effects of time period, stratification group and stratification group by time period interactions on CD4 counts were tested using a mixed model. Univariate comparisons among patient characteristics and responses were performed using Fisher's exact test or the Wilcoxon rank sum test.

RESULTS

At initiation of TI, the median CD4 count was 799 cells/microL. TI duration was a median of 7.1 months. HIV RNA rebounded to a median maximum level of 75 000 copies/mL. Maximum viral rebound was significantly greater in patients who were male, had lipodystrophy and had zenith HIV RNA prior to TI of >/=50 000 copies/mL. Lower CD4 cell counts were observed during TI in patients with lipodystrophy, zenith HIV RNA >/=50 000 copies/mL, history of AIDS, HIV infection >/=5 years and presuppression CD4 count </=350 cells/muL. Patients who reinitiated therapy had shorter TI duration, presuppression CD4 count </=350 cells/microL, previous AIDS diagnosis and lipodystrophy. No patients developed adverse or AIDS-defining events during TI.

CONCLUSIONS

Long-term TI resulted in greater immune deterioration in patients with high viral set points or low CD4 cell counts prior to initiation of suppressive antiretroviral therapy.

Authors+Show Affiliations

Division of Infectious Diseases, The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. cachenba@medicine.bsd.uchicago.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15670246

Citation

Achenbach, C J., et al. "Extended Antiretroviral Treatment Interruption in HIV-infected Patients With Long-term Suppression of Plasma HIV RNA." HIV Medicine, vol. 6, no. 1, 2005, pp. 7-12.
Achenbach CJ, Till M, Palella FJ, et al. Extended antiretroviral treatment interruption in HIV-infected patients with long-term suppression of plasma HIV RNA. HIV Med. 2005;6(1):7-12.
Achenbach, C. J., Till, M., Palella, F. J., Knoll, M. D., Terp, S. M., Kalnins, A. U., & Murphy, R. L. (2005). Extended antiretroviral treatment interruption in HIV-infected patients with long-term suppression of plasma HIV RNA. HIV Medicine, 6(1), 7-12.
Achenbach CJ, et al. Extended Antiretroviral Treatment Interruption in HIV-infected Patients With Long-term Suppression of Plasma HIV RNA. HIV Med. 2005;6(1):7-12. PubMed PMID: 15670246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended antiretroviral treatment interruption in HIV-infected patients with long-term suppression of plasma HIV RNA. AU - Achenbach,C J, AU - Till,M, AU - Palella,F J, AU - Knoll,M D, AU - Terp,S M, AU - Kalnins,A U, AU - Murphy,R L, PY - 2005/1/27/pubmed PY - 2005/4/20/medline PY - 2005/1/27/entrez SP - 7 EP - 12 JF - HIV medicine JO - HIV Med VL - 6 IS - 1 N2 - OBJECTIVES: Evaluation of extended treatment interruption (TI) in chronic HIV infection among patients successfully treated with antiretroviral therapy. METHODS: An observational analysis of 25 patients in a prospectively followed cohort with chronic HIV infection, viral loads <500 HIV-1 RNA copies/mL for at least 6 months, and an interruption in therapy of >/=28 days duration was carried out. Follow up was divided into 3-month time periods for analysis. The effects of time period, stratification group and stratification group by time period interactions on CD4 counts were tested using a mixed model. Univariate comparisons among patient characteristics and responses were performed using Fisher's exact test or the Wilcoxon rank sum test. RESULTS: At initiation of TI, the median CD4 count was 799 cells/microL. TI duration was a median of 7.1 months. HIV RNA rebounded to a median maximum level of 75 000 copies/mL. Maximum viral rebound was significantly greater in patients who were male, had lipodystrophy and had zenith HIV RNA prior to TI of >/=50 000 copies/mL. Lower CD4 cell counts were observed during TI in patients with lipodystrophy, zenith HIV RNA >/=50 000 copies/mL, history of AIDS, HIV infection >/=5 years and presuppression CD4 count </=350 cells/muL. Patients who reinitiated therapy had shorter TI duration, presuppression CD4 count </=350 cells/microL, previous AIDS diagnosis and lipodystrophy. No patients developed adverse or AIDS-defining events during TI. CONCLUSIONS: Long-term TI resulted in greater immune deterioration in patients with high viral set points or low CD4 cell counts prior to initiation of suppressive antiretroviral therapy. SN - 1464-2662 UR - https://www.unboundmedicine.com/medline/citation/15670246/Extended_antiretroviral_treatment_interruption_in_HIV_infected_patients_with_long_term_suppression_of_plasma_HIV_RNA_ L2 - https://doi.org/10.1111/j.1468-1293.2005.00257.x DB - PRIME DP - Unbound Medicine ER -