Treatment during primary HIV infection does not lower viral set point but improves CD4 lymphocytes in an observational cohort
| Autor: | C, Koegl, E, Wolf, N, Hanhoff, H, Jessen, K, Schewe, M, Rausch, J, Goelz, A, Goetzenich, H, Knechten, H, Jaeger, W, Becker, I, Becker-Boost, D, Berzow, B, Beiniek, J, Brust, D, Shcuster, S, Dupke, S, Fenske, H J, Gellermann, R, Gippert, P, Hartmann, B, Hintsche, E, Jaegel-Guedes, J, Gölz, J, Koelzsch, E B, Helm, G, Knecht, I, Lochet, P, Gute, S, Mauruschat, S, Mauss, V, Miasnikov, F A, Mosthaf, M, Freiwald, B, Reuter, H M, Schalk, B, Schappert, E, Schnaitmann, I, Schneider, W, Schüler-Maué, C, Schuler, T, Seidel, W, Starke, A, Ulmer, M, Müller, I, Weitner, C, Zamani, A, Hanmond, K, Ross, A, Bottlaender, C, Hoffmann, A, Dix, A, Schneidewind, M, Lademann |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty CD4 Lymphocytes Decreased Time Factors Adolescent antiretroviral therapy lcsh:Medicine HIV Infections Kaplan-Meier Estimate Gastroenterology Primary HIV infection Cohort Studies Young Adult Internal medicine Antiretroviral Therapy Highly Active HIV Seropositivity Outcome Assessment Health Care medicine Humans Multicenter Studies as Topic In patient Seroconversion Proportional Hazards Models business.industry Research lcsh:R HIV General Medicine Primary HIV Infection Middle Aged Viral Load Set point viral set point CD4 Lymphocyte Count CD4 lymphocytes Immunology Cohort HIV-1 Female business Viral load After treatment |
| Zdroj: | European Journal of Medical Research European Journal of Medical Research, Vol 14, Iss 7, p 277 (2009) |
| ISSN: | 0949-2321 |
| Popis: | Objective To investigate if early treatment of primary HIV-1 infection (PHI) reduces viral set point and/or increases CD4 lymphocytes. Methods Analysis of two prospective multi-centre PHI cohorts. HIV-1 RNA and CD4 lymphocytes in patients with transient treatment were compared to those in untreated patients. Time to CD4 lymphocyte decrease below 350/μl after treatment stop or seroconversion was calculated using Kaplan-Meier and Cox-PH-regression analyses. Results 156 cases of PHI were included, of which 100 had received transient HAART (median treatment time 9.5 months) and 56 remained untreated. Median viral load (563000 cop/ml vs 240000 cop/ml; p < 0.001) and median CD4 lymphocyte (449/μl vs. 613/μl; p < 0.01) differed significantly between treated and untreated patients. Median viral load was 38056 copies/ml in treated patients (12 months after treatment stop) and 52880 copies/ml in untreated patients (12 months after seroconversion; ns). Median CD4 lymphocyte change was +60/μl vs. -86/μl (p = 0.01). Median time until CD4 lymphocytes decreased to < 350/μl (including all patients with CD4 lymphocytes < 500/μl during seroconversion) was 20.7 months in treated patients after treatment stop and 8.3 months in untreated patents after seroconversion (p < 0.01). Cox-PH analyses adjusting for baseline VL, CD4 lymphocytes, stage of early infection and symptoms confirmed these differences. Conclusions Treatment during PHI did not lower viral set point. However, patients treated during seroconversion had an increase in CD4 lymphocytes, whereas untreated patients experienced a decrease in CD4 lymphocytes. Time until reaching CD4 lymphocytes < 350/μl was significantly shorter in untreated than in treated patients including patients with CD4 lymphocytes < 500/μl during seroconversion. |
| Databáze: | OpenAIRE |
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