Residual viraemia in subjects with chronic HIV infection and viral load <50 copies/ml: The impact of highly active antiretroviral therapy

Lucia Palmisano, Marina Giuliano, Emanuele Nicastri, Maria Franca Pirillo, Mauro Andreotti, Clementina M. Galluzzo, Raffaella Bucciardini, Vincenzo Fragola, Massimo Andreoni, Stefano Vella

Research output: Contribution to journalArticle

Abstract

Objective: To determine factors associated with <2.5 copies/ml plasma HIV RNA in subjects treated with highly active antiretroviral therapy (HAART) and with viraemia <50 copies/ml. Design: Cross-sectional analysis of 84 HIV-positive patients taking HAART with plasma HIV RNA <50 copies/ml for at least 6 months and no history of virological failure. Methods: Current HAART therapy was based on a non-nucleoside reverse transcriptase inhibitor (NNRTI) in 66%, a protease inhibitor in 26% and nucleoside reverse transcriptase inhibitors in 7%. Viraemia levels were measured using a modified ultrasensitive Roche Amplicor HIV-1 Monitor test able to quantify plasma HIV RNA to a lower limit of 2.5 copies/ml; proviral DNA was measured with a real-time polymerase chain reaction assay. Analysis of variance and multiple logistic regression analysis were utilized to test for associations between residual replication and other variables. Results: Residual HIV viraemia > 2.5 copies/ml was found in 50% of subjects; 94% of subjects had detectable proviral DNA (≥ 20 copies/106 peripheral blood mononuclear cells) and 21% had archived mutations. Usage of a NNRTI-based HAART was the only independent predictor of viral suppression below the cut-off value of the modified ultrasensitive assay. Conclusions: In our population, NNRTI-based HAART seems to have a stronger impact on residual replication than protease inhibitor-based HAART. This finding may be considered in therapeutic decisions such as the choice of initial HAART regimen and the interruption or simplification of treatment.

Original languageEnglish
Pages (from-to)1843-1847
Number of pages5
JournalAIDS (London, England)
Volume19
Issue number16
Publication statusPublished - Nov 4 2005

Keywords

  • HAART
  • HIV-1
  • HIV-1 DNA
  • Mutations
  • Plasma HIV-1 RNA

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Palmisano, L., Giuliano, M., Nicastri, E., Pirillo, M. F., Andreotti, M., Galluzzo, C. M., Bucciardini, R., Fragola, V., Andreoni, M., & Vella, S. (2005). Residual viraemia in subjects with chronic HIV infection and viral load <50 copies/ml: The impact of highly active antiretroviral therapy. AIDS (London, England), 19(16), 1843-1847.