Prognostic factors of long-term CD4+ count-guided interruption of antiretroviral treatment

L. Sarmati, C. Andreoni, E. Nicastri, C. Tommasi, A. Buonomini, G. D'Ettorre, A. Corpolongo, L. Dori, M. Montano, A. Volpi, P. Narciso, V. Vullo, M. Andreoni

Research output: Contribution to journalArticlepeer-review

Abstract

Aim of the study was to determine predictors of the duration of antiretroviral treatment interruption in patients infected with HIV. This pilot prospective, open-label, multicenter trial comprised 62 HIV-seropositive subjects who decided voluntarily to interrupt therapy after two or more years of successful HAART. The primary end-point was the time to patients being free of therapy before reaching a CD4+ cell count ≤350/μl. Fifteen of 62 patients remained in treatment interruption for more than 180 days. Patients restarting therapy had higher HIV-DNA levels (P = 0.05), were treated more frequently with NNRTI-drugs (P = 0.02), had a shorter period of HAART (P = 0.046), and lower CD4+ cell counts after day 14 of interruption of treatment (P = 0.04). Multivariate regression analysis showed that less than 323 baseline proviral HIV-DNA cp/106 PBMCs and more than 564 CD4 cells/μl at day 14 after interruption were associated independently with a reduced risk of restarting treatment (P = 0.041 and P = 0.012, respectively). A score based on CD4+ cell counts at nadir, at baseline, at week 2 of treatment interruption, and on baseline HIV-DNA values can identify patients with a prolonged period free safely of treatment.

Original languageEnglish
Pages (from-to)481-487
Number of pages7
JournalJournal of Medical Virology
Volume81
Issue number3
DOIs
Publication statusPublished - Mar 2009

Keywords

  • CD4+ cell count
  • Cellular HIV-DNA quantitation
  • HIV infection
  • Interruption of HAART

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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