Abstract
Background: We tested whether pre-HAART viraemia affects the achievement and maintenance of virological success in HIV-1-infected patients starting modern irstline therapies. Methods: A total of 1,430 patients starting their irst HAART (genotype-tailored) in 2008 (median; IQR: 2006-2009) were grouped according to levels of pre-HAART viraemia (≤30,000, 30,001-100,000, 100,001-300,000, 300,001-500,000 and >500,000 copies/ml). The impact of pre-therapy viraemia on the time to virological success (viraemia ≤50 copies/ml) and on the time to virological rebound (irst of two consecutive viraemia values >50 copies/ml after virological success) were evaluated by Kaplan-Meier curves and Cox regression analyses. Results: Median pre-HAART viraemia was 5.1 log10 copies/ml (IQR 4.5-5.5), and 53% of patients had viraemia >100,000 copies/ml. By week 48, the prevalence of patients reaching virological success was >90% in all pre-HAART viraemia ranges, with the only exception of range >500,000 copies/ml (virological success =83%; P500,000 copies/ml showed the lowest hazard of virological undetectability after adjusting for age, gender, pre-HAART CD4+ T-cell count, transmitted drug resistance, calendar year and third drug administered (adjusted hazard ratio [95% CI]: 0.27 [0.21, 0.35]; P500,000 copies/ml was also associated with higher probability of virological rebound compared with patients belonging to lower viraemia strata at weeks 4, 12 and 24 (P=0.050). Conclusions: At the time of modern HAART, and even though an average >90% of virological success, high pre-HAART viraemia remains an independent factor associated with delayed and decreased virological success. Patients starting HAART with >500,000 copies/ml represent a signiicant population that may deserve special attention.
| Original language | English |
|---|---|
| Pages (from-to) | 867-876 |
| Number of pages | 10 |
| Journal | Antiviral Therapy |
| Volume | 18 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2013 |
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ASJC Scopus subject areas
- Pharmacology
- Pharmacology (medical)
- Infectious Diseases
Cite this
Impact of pre-therapy viral load on virological response to modern irst-line HAART. / Santoro, Maria Mercedes; Armenia, Daniele; Alteri, Claudia; Flandre, Philippe; Calcagno, Andrea; Santoro, Mario; Gori, Caterina; Fabeni, Lavinia; Bellagamba, Rita; Borghi, Vanni; Forbici, Federica; Latini, Alessandra; Palamara, Guido; Libertone, Raffaella; Tozzi, Valerio; Boumis, Evangelo; Tommasi, Chiara; Pinnetti, Carmela; Ammassari, Adriana; Nicastri, Emanuele; Buonomini, Annarita; Svicher, Valentina; Andreoni, Massimo; Narciso, Pasquale; Mussini, Cristina; Antinori, Andrea; Ceccherini-Silberstein, Francesca; Perri, Giovanni Di; Perno, Carlo Federico.
In: Antiviral Therapy, Vol. 18, No. 7, 2013, p. 867-876.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Impact of pre-therapy viral load on virological response to modern irst-line HAART
AU - Santoro, Maria Mercedes
AU - Armenia, Daniele
AU - Alteri, Claudia
AU - Flandre, Philippe
AU - Calcagno, Andrea
AU - Santoro, Mario
AU - Gori, Caterina
AU - Fabeni, Lavinia
AU - Bellagamba, Rita
AU - Borghi, Vanni
AU - Forbici, Federica
AU - Latini, Alessandra
AU - Palamara, Guido
AU - Libertone, Raffaella
AU - Tozzi, Valerio
AU - Boumis, Evangelo
AU - Tommasi, Chiara
AU - Pinnetti, Carmela
AU - Ammassari, Adriana
AU - Nicastri, Emanuele
AU - Buonomini, Annarita
AU - Svicher, Valentina
AU - Andreoni, Massimo
AU - Narciso, Pasquale
AU - Mussini, Cristina
AU - Antinori, Andrea
AU - Ceccherini-Silberstein, Francesca
AU - Perri, Giovanni Di
AU - Perno, Carlo Federico
PY - 2013
Y1 - 2013
N2 - Background: We tested whether pre-HAART viraemia affects the achievement and maintenance of virological success in HIV-1-infected patients starting modern irstline therapies. Methods: A total of 1,430 patients starting their irst HAART (genotype-tailored) in 2008 (median; IQR: 2006-2009) were grouped according to levels of pre-HAART viraemia (≤30,000, 30,001-100,000, 100,001-300,000, 300,001-500,000 and >500,000 copies/ml). The impact of pre-therapy viraemia on the time to virological success (viraemia ≤50 copies/ml) and on the time to virological rebound (irst of two consecutive viraemia values >50 copies/ml after virological success) were evaluated by Kaplan-Meier curves and Cox regression analyses. Results: Median pre-HAART viraemia was 5.1 log10 copies/ml (IQR 4.5-5.5), and 53% of patients had viraemia >100,000 copies/ml. By week 48, the prevalence of patients reaching virological success was >90% in all pre-HAART viraemia ranges, with the only exception of range >500,000 copies/ml (virological success =83%; P500,000 copies/ml showed the lowest hazard of virological undetectability after adjusting for age, gender, pre-HAART CD4+ T-cell count, transmitted drug resistance, calendar year and third drug administered (adjusted hazard ratio [95% CI]: 0.27 [0.21, 0.35]; P500,000 copies/ml was also associated with higher probability of virological rebound compared with patients belonging to lower viraemia strata at weeks 4, 12 and 24 (P=0.050). Conclusions: At the time of modern HAART, and even though an average >90% of virological success, high pre-HAART viraemia remains an independent factor associated with delayed and decreased virological success. Patients starting HAART with >500,000 copies/ml represent a signiicant population that may deserve special attention.
AB - Background: We tested whether pre-HAART viraemia affects the achievement and maintenance of virological success in HIV-1-infected patients starting modern irstline therapies. Methods: A total of 1,430 patients starting their irst HAART (genotype-tailored) in 2008 (median; IQR: 2006-2009) were grouped according to levels of pre-HAART viraemia (≤30,000, 30,001-100,000, 100,001-300,000, 300,001-500,000 and >500,000 copies/ml). The impact of pre-therapy viraemia on the time to virological success (viraemia ≤50 copies/ml) and on the time to virological rebound (irst of two consecutive viraemia values >50 copies/ml after virological success) were evaluated by Kaplan-Meier curves and Cox regression analyses. Results: Median pre-HAART viraemia was 5.1 log10 copies/ml (IQR 4.5-5.5), and 53% of patients had viraemia >100,000 copies/ml. By week 48, the prevalence of patients reaching virological success was >90% in all pre-HAART viraemia ranges, with the only exception of range >500,000 copies/ml (virological success =83%; P500,000 copies/ml showed the lowest hazard of virological undetectability after adjusting for age, gender, pre-HAART CD4+ T-cell count, transmitted drug resistance, calendar year and third drug administered (adjusted hazard ratio [95% CI]: 0.27 [0.21, 0.35]; P500,000 copies/ml was also associated with higher probability of virological rebound compared with patients belonging to lower viraemia strata at weeks 4, 12 and 24 (P=0.050). Conclusions: At the time of modern HAART, and even though an average >90% of virological success, high pre-HAART viraemia remains an independent factor associated with delayed and decreased virological success. Patients starting HAART with >500,000 copies/ml represent a signiicant population that may deserve special attention.
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U2 - 10.3851/IMP2531
DO - 10.3851/IMP2531
M3 - Article
VL - 18
SP - 867
EP - 876
JO - Antiviral Therapy
JF - Antiviral Therapy
SN - 1359-6535
IS - 7
ER -