Initiation of HAART in drug-naive HIV type 1 patients prevents viral breakthrough for a median period of 35.5 months in 60% of the patients

K. Van Vaerenbergh, T. Harrer, J. C. Schmit, A. Carbonez, E. Fontaine, M. Kurowski, M. Grünke, P. Löw, A. Rascu, B. Schmidt, M. Schmitt, I. Thoelen, H. Walter, K. Van Laethem, M. Van Ranst, J. Desmyter, E. De Clercq, Anne Mike Vandamme

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24 Citations (Scopus)

Abstract

The introduction of potent combinations of antiviral drugs is a major breakthrough in the treatment of HIV. We investigated the long-term virologic outcome and the development of resistance after initiating highly active antiretroviral therapy (HAART) in drug-naive patients in daily clinical practice. Twenty-five treatment-naive HIV-1 patients were started on HAART. Fifteen patients responded with a drop in viral load below the limit of detection during 35.5 (interquartile range: 7) months of therapy. In 6 of 10 patients with virologic failure, virus with resistance-related mutations against the received drugs emerged. Compared with responders (R), nonresponding (NR) patients were in a later disease stage at therapy start (p = 0.0089) with lower CD4 cell counts at baseline (p = 0.040), and a lower proportion of nonresponders showed protease inhibitor (PI) levels aboveCmin (p = 0.049). More NR patients showed secondary PI mutations at baseline (p = 0.079), and the CCR2-64I coreceptor polymorphism was absent among NR patients, compared with 38.5% of R patients displaying CCR2-64I (p = 0.053), although the differences were not significant. In conclusion, starting HAART in antiretroviral drug-naive HIV-infected patients followed in daily clinical practice prevented viral breakthrough for up to 44 months in 60% of the patients. Virologic failure was associated with the development of resistance-related mutations, a later stage of disease at start of therapy and lower PI drug levels.

Original languageEnglish
Pages (from-to)419-426
Number of pages8
JournalAIDS Research and Human Retroviruses
Volume18
Issue number6
DOIs
Publication statusPublished - 2002
Externally publishedYes

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