Clinical and immunologic response without decrease in virus load in patients with AIDS after 24 months of highly active antiretroviral therapy

I Mezzaroma; M Carlesimo; E Pinter; D S Muratori; F Di Sora; F Chiarotti; M G Cunsolo; G Sacco; F Aiuti

doi:10.1086/313520

Clinical and immunologic response without decrease in virus load in patients with AIDS after 24 months of highly active antiretroviral therapy

Clin Infect Dis. 1999 Dec;29(6):1423-30. doi: 10.1086/313520.

Authors

I Mezzaroma¹, M Carlesimo, E Pinter, D S Muratori, F Di Sora, F Chiarotti, M G Cunsolo, G Sacco, F Aiuti

Affiliation

¹ Department of Allergy and Clinical Immunology, University of Rome "La Sapienza," Viale dell'Università, 00185 Rome, Italy.

PMID: 10585790
DOI: 10.1086/313520

Abstract

This study reports an analysis of clinical, virological, and immunologic outcomes in a cohort of 77 multidrug-experienced AIDS patients during 24 months of highly active antiretroviral therapy (HAART). Our results have shown a reduced risk of AIDS complications, prolonged survival, and immunologic benefit even in the absence of sustained virus suppression. The degree of immunodepression, the risk factors for HIV-1 infection, the use of 2 drugs instead of 3, and a change in protease inhibitor were independently correlated with virological failure. In the majority of studied patients, an increase in CD4+ T cells was observed after HAART. However, the increase was more pronounced in patients who showed a decrease in virus load than in those who did not. Moreover, we observed an absence of relapses among patients who permanently discontinued prophylaxis for Cytomegalovirus retinitis and atypical mycobacterial infections. Peripheral lipodystrophy developed in the majority of patients, regardless of treatment used and virological outcome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

AIDS-Related Opportunistic Infections / prevention & control
Acquired Immunodeficiency Syndrome / drug therapy*
Acquired Immunodeficiency Syndrome / immunology
Acquired Immunodeficiency Syndrome / mortality
Adult
Anti-HIV Agents / therapeutic use*
CD4-Positive T-Lymphocytes / cytology
CD4-Positive T-Lymphocytes / drug effects
Clinical Trials as Topic
Drug Therapy, Combination
Female
Follow-Up Studies
HIV Infections / drug therapy
HIV Infections / immunology
HIV Infections / mortality
HIV Protease Inhibitors / therapeutic use
HIV-1 / drug effects
HIV-1 / genetics
Humans
Logistic Models
Lymphocyte Count / drug effects
Male
Middle Aged
RNA, Viral / blood
RNA, Viral / drug effects
Retrospective Studies
Reverse Transcriptase Inhibitors / therapeutic use
Survival Analysis
T-Lymphocytes / cytology
T-Lymphocytes / drug effects
T-Lymphocytes / immunology
Time Factors
Treatment Outcome
Viral Load*

Substances

Anti-HIV Agents
HIV Protease Inhibitors
RNA, Viral
Reverse Transcriptase Inhibitors