Cellular HIV-1 DNA quantitation in patients during simplification therapy with protease inhibitor-sparing regimens

Loredana Sarmati, Saverio Giuseppe Parisi, Emanuele Nicastri, Gabriella D'Ettorre, Carolina Andreoni, Luca Dori, Francesca Gatti, Marco Montano, Anna Rita Buonomini, Caterina Boldrin, Giorgio Palù, Vincenzo Vullo, Massimo Andreoni

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Simplified regimens containing protease-inhibitors (PI)-sparing combinations were used in patients with virological suppression after prolonged highly active antiretroviral therapy. This study evaluated the total HIV-1 DNA quantitation as a predictor of long-term success for PI-sparing simplified therapy. Sixty-two patients were enrolled in a prospective non-randomized cohort. All patients have been receiving a triple-therapy regimen, two nucleoside reverse transcriptase inhibitors (NRTIs) plus one PI, for at least 9 months and were characterized by undetectable plasma HIV-1 RNA levels (6 PBMCs) had a significant higher CD4 cell count at nadir (P = 0.003) and at enrolment (P = 0.001) with respect to patients with HIV-DNA levels above the median value. At month 18, 53 out of 62 (85%) patients on simplified regimen showed virological success, 4 (6.4%) patients experienced virological failure and 5 (8%) patients showed viral blip. At logistic regression analysis, HIV-DNA levels below 226 copies/106 PBMCs at baseline were associated independently to a reduced risk of virological failure or viral blip during simplified therapy (OR 0.002, 95% CI 0.001-0.46, P = 0.025). The substitution of PI with NRTI or non-NRTIs may represent an effective treatment option. Indeed, treatment failure or viral blip were experienced by 6% and 8% of the patients on simplified therapy, respectively. In addition, sustained suppression of the plasma viral load was significantly correlated with low levels of proviral DNA before treatment simplification.

Original languageEnglish
Pages (from-to)880-886
Number of pages7
JournalJournal of Medical Virology
Issue number7
Publication statusPublished - Jul 2007


  • HIV infection
  • Simplification therapy

ASJC Scopus subject areas

  • Virology


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