Katlama C, Costagliola D, Samri A, Alatrakchi N, Marcelin AG, Biligui A, Agher R, Astriti M, Calvez V, Autran B, Duvivier C; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 623.
INSERM EMI 0214
OBJECTIVES: To describe the clinical, virological and immunological status of patients (pt) with persistent low viral replication (LVL), compared with patients with virological failure (VF) and full viral suppression (FVS). METHODS: Cross-sectional comparative study of three groups: LVL (VL >10000 cp/ml), VF (VL >10000 cp/ml) and FVS (VL <20 cp/ml) during at least 18 months. Comparisons were made between LVL vs VF (C1) and LVL vs FVS (C2). RESULTS: Seventy-one pts were included (LVL: 28 pts; VF: 14 pts; FVS: 29 pts) Median duration of HIV infection was 11 years. Pts with CDC stage C were 36% in LVL versus (vs) 71% in VF (p 0.02) vs 35% in FVS (ns). Median CD4 count were 341/mm3 in LVL pts, 53/mm3 in VF (C1: P<0.001) and 479/mm3 in FVS (C2: ns). Median VL were 3.21 log10 cp/ml in LVL, 4.96 log10 cp/ml in VF (C1: P<0.001) and 1.3 log10 cp/ml in FVS (C2: P<0.001). Dual NRTI regimen were more frequent in LVL (25%) than in VF (7%) (P=0.001) vs 10% in FVS (P=ns). Genotypic analyses showed similar number of mutations in RT gene (four mutations) between LVL and VF despite less prior drug exposure (4 vs 6 NRTIs; P=0.001) but lower number of major PI mutations (2 vs 3.5; P=0.009) in those with PI exposure. The T helper status was characterized by similar responses to recall antigens in LVL vs Fvs In contrast, both CD4 and CD8 responses to HIV were significantly more frequent and intense in LVL compared to FVS (P=0.04 and 0.008 for CD4 and CD8 responses respectively). After an additional 17.4 months of follow-up, 54% of LVL patients still belong to this group. CONCLUSION: Low viral replication is associated with presence of ARV mutations, a tendency to a small depletion in CD4 that is stable over the time, preserved immune responses against recall antigens and with a higher CD4 and CD8 anti-HIV responses in comparison to patients with full viral suppression. Whether these responses are able to control to viral replication remain to be determined.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Cross-Sectional Studies
- HIV Infections
- HIV Seropositivity
- Humans
- virology
Other ID:
UI: 102262905
From Meeting Abstracts