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Long-term follow-up of asymptomatic HIV-infected patients who discontinued antiretroviral therapy.
Clin Infect Dis. 2005 Aug 01; 41(3):390-4.CI

Abstract

BACKGROUND

Whether asymptomatic human immunodeficiency virus (HIV)-infected patients can interrupt treatment remains unknown.

METHODS

We performed a prospective, observational study of 46 patients who started therapy with >300 CD4+ cells/mm3 and/or <70,0000 HIV-1 RNA copies/mL. Patients had been receiving highly active antiretroviral therapy (HAART) for at least 6 months. HAART was discontinued, and plasma HIV-1 RNA loads and CD4+ cell counts were determined at 4-month intervals.

RESULTS

At the time of HAART discontinuation, the median CD4+ cell count was 793 cells/mm3, and all patients had undetectable viral loads. A rapid decrease of 173 cells/mm3 in the median CD4+ cell count was observed during the first 4 months after HAART was stopped, followed by a slower decrease of 234 cells/mm3 between months 5 and 20. The decrease in the median CD4+ cell count early after HAART discontinuation was inversely correlated with the increase that occurred during receipt of therapy (r=-0.653) and with the count at the time of HAART discontinuation (r=-0.589). The decrease in the median CD4+ cell count after the fourth month without HAART was correlated with the nadir count before HAART initiation (r=-0.349) and the increase during treatment (r=-0.322). The median follow-up duration was 20 months. After 12, 24, and 36 months of observation, 33 patients (71.7%), 22 patients (47.8%), and 16 patients (34.7%), respectively, remained free of therapy. Adverse clinical events were not seen, and all patients who reinitiated HAART responded rapidly.

CONCLUSION

Selected asymptomatic HIV-infected patients can safely discontinue therapy for prolonged periods of time.

Authors+Show Affiliations

Division of Infectious Diseases and Immunology, Department of Medicine, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain. mlfernandez@fjd.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16007538

Citation

Fernández Guerrero, Manuel L., et al. "Long-term Follow-up of Asymptomatic HIV-infected Patients Who Discontinued Antiretroviral Therapy." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 41, no. 3, 2005, pp. 390-4.
Fernández Guerrero ML, Rivas P, Molina M, et al. Long-term follow-up of asymptomatic HIV-infected patients who discontinued antiretroviral therapy. Clin Infect Dis. 2005;41(3):390-4.
Fernández Guerrero, M. L., Rivas, P., Molina, M., Garcia, R., & De Górgolas, M. (2005). Long-term follow-up of asymptomatic HIV-infected patients who discontinued antiretroviral therapy. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 41(3), 390-4.
Fernández Guerrero ML, et al. Long-term Follow-up of Asymptomatic HIV-infected Patients Who Discontinued Antiretroviral Therapy. Clin Infect Dis. 2005 Aug 1;41(3):390-4. PubMed PMID: 16007538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of asymptomatic HIV-infected patients who discontinued antiretroviral therapy. AU - Fernández Guerrero,Manuel L, AU - Rivas,Pablo, AU - Molina,Mercedes, AU - Garcia,Rosa, AU - De Górgolas,Miguel, Y1 - 2005/06/22/ PY - 2005/03/02/received PY - 2005/03/23/accepted PY - 2005/7/12/pubmed PY - 2006/9/26/medline PY - 2005/7/12/entrez SP - 390 EP - 4 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 41 IS - 3 N2 - BACKGROUND: Whether asymptomatic human immunodeficiency virus (HIV)-infected patients can interrupt treatment remains unknown. METHODS: We performed a prospective, observational study of 46 patients who started therapy with >300 CD4+ cells/mm3 and/or <70,0000 HIV-1 RNA copies/mL. Patients had been receiving highly active antiretroviral therapy (HAART) for at least 6 months. HAART was discontinued, and plasma HIV-1 RNA loads and CD4+ cell counts were determined at 4-month intervals. RESULTS: At the time of HAART discontinuation, the median CD4+ cell count was 793 cells/mm3, and all patients had undetectable viral loads. A rapid decrease of 173 cells/mm3 in the median CD4+ cell count was observed during the first 4 months after HAART was stopped, followed by a slower decrease of 234 cells/mm3 between months 5 and 20. The decrease in the median CD4+ cell count early after HAART discontinuation was inversely correlated with the increase that occurred during receipt of therapy (r=-0.653) and with the count at the time of HAART discontinuation (r=-0.589). The decrease in the median CD4+ cell count after the fourth month without HAART was correlated with the nadir count before HAART initiation (r=-0.349) and the increase during treatment (r=-0.322). The median follow-up duration was 20 months. After 12, 24, and 36 months of observation, 33 patients (71.7%), 22 patients (47.8%), and 16 patients (34.7%), respectively, remained free of therapy. Adverse clinical events were not seen, and all patients who reinitiated HAART responded rapidly. CONCLUSION: Selected asymptomatic HIV-infected patients can safely discontinue therapy for prolonged periods of time. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16007538/Long_term_follow_up_of_asymptomatic_HIV_infected_patients_who_discontinued_antiretroviral_therapy_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/431487 DB - PRIME DP - Unbound Medicine ER -