Greene JB, Sedorowitz M, Holzman RS, Handel JL, Felice JA; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. MoPeB2171.
J.B. Greene, NYU School of Medicine, 317 E. 34th Street, Fourth Floor, New York, N.Y. 10016, United States, Tel.: +1 212 981 7230, Fax: +1 212 726 7452, E-mail: greenj09@med.nyu.edu
Background: When maximal viral suppression is the goal of HAART, drug regimens become complex and more toxic. The study objective was to seek differences in clinical course between patients whose HIV is maximally, and sub-maximally suppressed. Methods: A practice with 600 HIV patients has been part of a large observational database. The clinicians `JBG, JLH' incorporated ultrasensitive PCR assays into practice on 9/1/98. For patients on HAART whose PCR remained >400 copies, HAART was not intensified even though HIV was detectable by more sensitive assays. Patients who had PCR values >400 with at least one 2nd generation assay performed between 9/1/98 and 3/30/99 were studied. 95 patients were divided into two cohorts. Cohort I `n = 54' was below detection levels by both 1st and 2nd generation PCR. Cohort II `n = 41' was detectable only by 2nd generation PCR `with limits of 13,25, or 40 cpm'. Results: Cohorts I/II were similar with regard to age `49.9 v 47.8 yr', HIV risk factors, race, sex, time since HIV diagnosis `9.6 v 10.1 yr', time on HAART `39 v 38 mo', and number of HAART regimens. The clinical performance of both cohorts was indistinguishable. Mean change in CD-4 cells were +240 `I' and +273 `II'. Incidence of OI per 1000 pt. mos was 7.8 `I' and 6.94 `II'. No HIV-related deaths occurred in either group. No differences in Karnofsky score, hospital days or virologic failure `defined as 2 consecutive PCRs >400' were observed. Conclusion: Optimal clinical response to HAART may not require maximal viral suppression.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- Biological Assay
- HIV Infections
- HIV Seropositivity
- Health Personnel
- Humans
- Incidence
- Polymerase Chain Reaction
- Prognosis
- Research
Other ID:
UI: 102237771
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