Moses A, Waring V, Salit I, Logue K, Humar A, Walmsley S; International Conference on AIDS.

Int Conf AIDS. 1998; 12: 341 (abstract no. 22387).

Toronto Hospital, ON, Canada.

BACKGROUND: Following the publication of the International AIDS Society-USA guidelines for antiretroviral (AR) therapy and the availability of viral load (VL) testing many patients (pts) changed their AR therapy in attempts to achieve maximal VL suppression (< 500 copies/ml). OBJECTIVE: To determine what portion of pts in clinical practice achieve maximal VL suppression with a change in therapy in response to a detectable VL. To identify factors which predict which pts reach this goal. METHODS: Retrospective case review of 296 randomly selected pts attending a hospital based tertiary care HIV clinic. Pt data was collected from the time of their first VL determination (available in our centre in 11/96) until 12/97. RESULTS: Of the 296 pts, 48 (16%) had a VL < 500 copies/ml through the entire study period and are excluded. An additional 14 pts with only one VL measure and are also excluded. Of the remaining 234 pts, 185 had a change in therapy in response to a detectable VL and form the cohort for the analysis. Suppression of VL to < 500 copies/ml was achieved in 118 (64%) pts. Univariate analysis demonstrated that pts who achieved maximal viral suppression with a change in therapy were more likely to have a higher mean baseline CD4 count (279 vs 165/mm3, p < .001) and lower mean baseline VL (4.2 log copies/ml vs 4.5 log copies/ml, p = .008). Prior use of PI was strongly predictive of failure to maximally suppress VL (54% vs 75%, p = .006). The number of AR agents changed was not different between the 2 groups (2.27 vs 2.33, p > .05). Logistic regression confirmed baseline CD4 (OR 1.4 per 100/mm3 cell increase, 95% CI 1.13-1.75, p = .003) and prior lack of PI use (OR 1.96, 95% CI 1.02-3.80, p = .045) as predictors of maximal suppression. CONCLUSION: Maximal viral suppression was possible for the majority of pts in our out-patient clinic setting. This response was more likely for pts with higher CD4 counts and was less likely for those with PI experience.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-HIV Agents
• CD4 Lymphocyte Count
• HIV
• HIV Infections
• HIV Protease Inhibitors
• Humans
• Viral Load
• psychology
• virology

Other ID:

• 98392524

UI: 102228426

From Meeting Abstracts