Ramacciotti TP, Smith DE, Cunningham P, Cooper DA, Kaldor JM; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. ThPeB7200.

National Centre for HIV Epidemiology and Clinical Research, Sydney, Australia

BACKGROUND: We decided to assess immunologic effects of immediate versus delayed ARV therapy in patients identified at time of primary HIV infection, who consented to follow up in the Australian PHI cohort from 1984 to present. METHODS: We reviewed 866 serial CD4 results from adults receiving any ARV therapy, either immediate (ITx) (N=87) or delayed (DTx) (> 6 months post-infection, N=153). CD4 and viral load results from the DTx group were compared with those of the ITx at baseline, 12, 24, 48, 72, and 96 weeks after the start of treatment. Estimates of HIV infection dates and interval from infection to treatment were determined by last negative and first positive ELISA dates, earliest and latest dates of exposure, and onset dates of PHI symptoms. To circumvent bias potentially introduced by the transient HIV viremia and CD4 depletion seen early in PHI, comparative follow up times were shifted forward by 12 weeks from date of infection for the immediately treated group. RESULTS: Analysis of data for 245 adult seroconverters (91% MSM contact, 98% male, mean age at infection 32.3 years) provided the following findings: 1) Median time from HIV infection to start of therapy was 40 vs. 1177 days in the ITx and DTx treatment groups, respectively; 2) Baseline data stratified by DTx versus ITx treatment showed no significant difference in mean log10 RNA. However, mean log10 decrease from baseline was significantly greater in the immediately treated group at weeks 12, 48, and approached significant difference at 24 weeks; 3) Mean CD4 counts were significantly different in the ITx group at baseline (313 v 644), but mean CD4 change from baseline was not significantly different at any later time point . CONCLUSIONS: Analyses of this large seroconverter cohort, and the large number initially declining ARV treatment reveal better early virologic responses, but no significantly different immunologic responses, to therapy in patients starting ARV therapy during PHI.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adult
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• Drug Therapy, Combination
• HIV Infections
• HIV Seropositivity
• Humans
• Male
• Viral Load
• Viremia
• drug therapy
• surgery
• therapy

Other ID:

• GWAIDS0017295

UI: 102254793

From Meeting Abstracts