 |
  
|
  |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
The Body Covers: The 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy
CD4-Guided Treatment Interruptions: A New Therapeutic Strategy
September 15, 2003 A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information! This was an observational, retrospective, multicenter study that examined structured treatment interruptions (STI) based on CD4 count thresholds. The inclusion criteria were: HAART treatment longer than 12 months, CD4 nadir more than 250 cells, CD4 more than 500 cells prior to STI, and interruption longer than four weeks. The criteria for restarting treatment was a CD4 count lower than 350 cells or the patient's choice to restart. One hundred and forty patients were enrolled in this study. When they had been initially treated for HIV infection, their median CD4 count was 410 cells and their median HIV-RNA (viral load) was 4.41 log10 copies/mL. Patients had been treated for a median of 3.5 years prior to the STI and at the time of the treatment interruption their median CD4 count was 804 cells and HIV-RNA was 1.7 log10. In this study, 53.6 percent of the patients were still off therapy as of April 2003. Because of a decline in CD4 cells to below 350, 24.3 percent of the patients restarted treatment. An additional 22.1 percent of the patients made the decision to restart treatment even though their CD4 count had not dropped below 350 cells. Overall, the median duration before treatment re-initiation was 104 weeks. Independent predictors of a low risk of treatment resumption were:
The conclusion of these authors was that patients on HAART could stay off treatment for long periods of time if they had a CD4 nadir more than 350 cells, an undetectable viral load for more than 12 months, a tendency for slow decline in CD4 cells prior to antiretroviral therapy, and a relatively low viral load rebound after STI. These study results fit well with another STI study presented at this meeting (for coverage by this author, click here) that demonstrates that patients with high CD4 counts while on HAART and with good nadir CD4 counts tend to do very well with prolonged amounts of time off therapy. A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information! Authored by: C. Mussini, A. Cozzi-Lepri, V. Borghi, A. De Luca, A. D'arminio, P. Ortolani, L. Sighinolfi, E. Barchi, L. E. Eriksson, G. Bratt, A. Bedini, N. Squillace, A. Cossarizza, R. Esposito Affiliations: University of Modena and Reggio Emilia, Modena, Italy; Royal Free Centre for HIV Medicine & Department of Primary Care and Population Science, London, United Kingdom; Catholic University, Rome, Italy; University of Milan, Milan, Italy; Department of Infectious Diseases, Rimini, Italy; Department of Infectious Diseases, Ferrara, Italy; Department of Infectious Diseases, Reggio Emilia, Italy; Virologiska avd/Dept of Virology, Solna, Sweden
This article was provided by The Body PRO. Copyright © Body Health Resources Corporation. All rights reserved.
|
Email
Glossary
Print-FriendlyThe Body: About The Body | Contact The Body | Content Policy | Content Providers | Advertise With Us | Site Map
Remedy Health Media: About Remedy Health Media | Contact Remedy Health Media | Terms of Use | Privacy Policy
The Body is a service of Remedy Health Media, LLC, 250 West 57th Street, New York, NY 10107. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.
