Clinical and Immunologic Response without Decrease in Virus Load in Patients with AIDS after 24 Months of Highly Active Antiretroviral Therapy

• Published in: Clinical infectious diseases 1999-12, Vol.29 (6), p.1423-1430
• Main Authors: Mezzaroma, Ivano, Carlesimo, Maurizio, Pinter, Elena, Muratori, Donatella Santini, Di Sora, Fiorella, Chiarotti, Flavia, Cunsolo, Maria Giovanna, Sacco, Giovanna, Aiuti, Fernando
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - immunology; Acquired Immunodeficiency Syndrome - mortality; Adult; AIDS; AIDS-Related Opportunistic Infections - prevention & control; AIDS/HIV; Anti-HIV Agents - therapeutic use; CD4 antigen; CD4-Positive T-Lymphocytes - cytology; CD4-Positive T-Lymphocytes - drug effects; Clinical Articles; Clinical Trials as Topic; Cytomegalovirus; Drug Therapy, Combination; Female; Follow-Up Studies; Highly active antiretroviral therapy; HIV 1; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - mortality; HIV Protease Inhibitors - therapeutic use; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus 1; Humans; Immunology; Infections; Logistic Models; Lymphocyte Count - drug effects; Male; Middle Aged; Retrospective Studies; Reverse Transcriptase Inhibitors - therapeutic use; RNA; RNA, Viral - blood; RNA, Viral - drug effects; Survival Analysis; T lymphocytes; T-Lymphocytes - cytology; T-Lymphocytes - drug effects; T-Lymphocytes - immunology; Time Factors; Treatment Outcome; Viral Load; Virology; Viruses
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/313520

This study reports an analysis of clinical, virological, and immunologic outcomes in a cohort of 77 multidrug-experienced AIDS patients during 24 months of highly active antiretroviral therapy (HAART). Our results have shown a reduced risk of AIDS complications, prolonged survival, and immunologic benefit even in the absence of sustained virus suppression. The degree of immunodepression, the risk factors for HIV-1 infection, the use of 2 drugs instead of 3, and a change in protease inhibitor were independently correlated with virological failure. In the majority of studied patients, an increase in CD4+ T cells was observed after HAART. However, the increase was more pronounced in patients who showed a decrease in virus load than in those who did not. Moreover, we observed an absence of relapses among patients who permanently discontinued prophylaxis for Cytomegalovirus retinitis and atypical mycobacterial infections. Peripheral lipodystrophy developed in the majority of patients, regardless of treatment used and virological outcome.