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Temporary treatment during primary HIV infection does not affect virologic response to subsequent long-term treatment.

Grijsen ML, Wit FW, Jurriaans S, Kroon FP, Schippers EF, Koopmans P, Gras L, Lange JM, Prins JM, Primo-SHM Study Gro - PLoS ONE (2014)

Bottom Line: Temporary cART during primary HIV-infection (PHI) did not select for drug resistance mutations after treatment interruption and did not affect the subsequent virological response to long-term cART.Our data demonstrate that fear of drug resistance development is not a valid argument to refrain from temporary early treatment during PHI.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, University of Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Amsterdam, the Netherlands.

ABSTRACT
Temporary cART during primary HIV-infection (PHI) did not select for drug resistance mutations after treatment interruption and did not affect the subsequent virological response to long-term cART. Our data demonstrate that fear of drug resistance development is not a valid argument to refrain from temporary early treatment during PHI.

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Viral decay after treatment (re)initiation of long-term cART in naive and early treated patients.
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pone-0089639-g001: Viral decay after treatment (re)initiation of long-term cART in naive and early treated patients.

Mentions: All naive and early treated patients achieved viral (re)suppression. The mean number of pVL measurements after (re)start of cART, upto and including the first undetectable pVL, was 2.3 (SD 1.2) in the naive and 2.3 (1.5) in the early treated patients, respectively (P = 0.87). The mean interval between pVL measurements was not significantly different for the two groups (53 (SD 23) vs. 50 (20) days, respectively, P = 0.54). Viral decay after treatment (re)initiation was similar between the naive and early treated patients: during the first four weeks the pVL decreased with 0.62 and 0.58 log10 copies/ml/week respectively (P = 0.32), from week four to eight with 0.087 and 0.13 log10 copies/ml/week (P = 0.37), and from eight weeks onward with 0.043 and 0.027 log10 copies/ml/week (P = 0.23) (Figure 1). Adjusting the viral decay for the difference in pVL at (re)start of long-term cART also showed no significant differences between the two groups (data not shown). The median time to viral (re)suppression in naive and early treated patients was 16.4 (IQR 9.6–20.6) and 16.6 (8.7–21.0) weeks, respectively (log-rank, P = 0.72). Figure 2 demonstrates that three years after (re)initiation of long-term cART the proportion of patients having an undetectable pVL was not significantly different between the naive and early treated patients. In addition, the CD4 count recovery after treatment (re)initiation showed no differences over time between the two groups (Figure 3).


Temporary treatment during primary HIV infection does not affect virologic response to subsequent long-term treatment.

Grijsen ML, Wit FW, Jurriaans S, Kroon FP, Schippers EF, Koopmans P, Gras L, Lange JM, Prins JM, Primo-SHM Study Gro - PLoS ONE (2014)

Viral decay after treatment (re)initiation of long-term cART in naive and early treated patients.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3974663&req=5

pone-0089639-g001: Viral decay after treatment (re)initiation of long-term cART in naive and early treated patients.
Mentions: All naive and early treated patients achieved viral (re)suppression. The mean number of pVL measurements after (re)start of cART, upto and including the first undetectable pVL, was 2.3 (SD 1.2) in the naive and 2.3 (1.5) in the early treated patients, respectively (P = 0.87). The mean interval between pVL measurements was not significantly different for the two groups (53 (SD 23) vs. 50 (20) days, respectively, P = 0.54). Viral decay after treatment (re)initiation was similar between the naive and early treated patients: during the first four weeks the pVL decreased with 0.62 and 0.58 log10 copies/ml/week respectively (P = 0.32), from week four to eight with 0.087 and 0.13 log10 copies/ml/week (P = 0.37), and from eight weeks onward with 0.043 and 0.027 log10 copies/ml/week (P = 0.23) (Figure 1). Adjusting the viral decay for the difference in pVL at (re)start of long-term cART also showed no significant differences between the two groups (data not shown). The median time to viral (re)suppression in naive and early treated patients was 16.4 (IQR 9.6–20.6) and 16.6 (8.7–21.0) weeks, respectively (log-rank, P = 0.72). Figure 2 demonstrates that three years after (re)initiation of long-term cART the proportion of patients having an undetectable pVL was not significantly different between the naive and early treated patients. In addition, the CD4 count recovery after treatment (re)initiation showed no differences over time between the two groups (Figure 3).

Bottom Line: Temporary cART during primary HIV-infection (PHI) did not select for drug resistance mutations after treatment interruption and did not affect the subsequent virological response to long-term cART.Our data demonstrate that fear of drug resistance development is not a valid argument to refrain from temporary early treatment during PHI.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, University of Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Amsterdam, the Netherlands.

ABSTRACT
Temporary cART during primary HIV-infection (PHI) did not select for drug resistance mutations after treatment interruption and did not affect the subsequent virological response to long-term cART. Our data demonstrate that fear of drug resistance development is not a valid argument to refrain from temporary early treatment during PHI.

Show MeSH
Related in: MedlinePlus