PURPOSE: To study whether and under what circumstances HIV can be controlled in chronically infected patients. METHOD: Nine patients treated with hydroxyurea and didanosine (PANDAs) were compared with 7 patients on highly active antiretroviral therapy (HAART) during an 8-week treatment interruption. Both groups had similar baseline viral load, CD4 count, and length of treatment. Treatment was resumed if viral rebound >10,000 copies/mL (virological failure) or CD4 count decrease below 200 cells/mm(3) (immunological failure) occurred in two consecutive measurements. RESULTS: None of the PANDAs failed. Viral rebound was spontaneously contained, and CD4 count remained stable. Four out of 7 patients in the HAART group failed to control HIV by week 6 and had to restart therapy due to either viremia rebound or CD4 decrease. Before therapy interruption, the PANDAs had a vigorous HIV-specific T cell immune response (median CD4VIR 1.2%), while the HAART-treated patients did not (median CD4VIR 0.2%) (CD4VIR represents the percentage of HIV-specific CD4 subpopulation expressing IFN-gamma within the total CD4 population [CD3+, CD4+, IFN-gamma+]). This difference was statistically significant (p =.002). CONCLUSION: This study shows that HIV can be controlled during therapy interruption in patients with established infection, and that control of viral replication correlates with vigorous anti-HIV specific immune responses.
PURPOSE: To study whether and under what circumstances HIV can be controlled in chronically infectedpatients. METHOD: Nine patients treated with hydroxyurea and didanosine (PANDAs) were compared with 7 patients on highly active antiretroviral therapy (HAART) during an 8-week treatment interruption. Both groups had similar baseline viral load, CD4 count, and length of treatment. Treatment was resumed if viral rebound >10,000 copies/mL (virological failure) or CD4 count decrease below 200 cells/mm(3) (immunological failure) occurred in two consecutive measurements. RESULTS: None of the PANDAs failed. Viral rebound was spontaneously contained, and CD4 count remained stable. Four out of 7 patients in the HAART group failed to control HIV by week 6 and had to restart therapy due to either viremia rebound or CD4 decrease. Before therapy interruption, the PANDAs had a vigorous HIV-specific T cell immune response (median CD4VIR 1.2%), while the HAART-treated patients did not (median CD4VIR 0.2%) (CD4VIR represents the percentage of HIV-specific CD4 subpopulation expressing IFN-gamma within the total CD4 population [CD3+, CD4+, IFN-gamma+]). This difference was statistically significant (p =.002). CONCLUSION: This study shows that HIV can be controlled during therapy interruption in patients with established infection, and that control of viral replication correlates with vigorous anti-HIV specific immune responses.
Authors: Robert McLinden; Robert Paris; Victoria Polonis; Nicole Close; Zhaohui Su; Cecilia Shikuma; David Margolis; Jerome Kim Journal: AIDS Date: 2012-07-17 Impact factor: 4.177
Authors: William Borkowsky; Ram Yogev; Petronella Muresan; Elizabeth McFarland; Lisa Frenkel; Terry Fenton; Edmond Capparelli; Jack Moye; Paul Harding; Nina Ellis; Barbara Heckman; Joyce Kraimer Journal: Vaccine Date: 2008-01-04 Impact factor: 3.641
Authors: Emmanouil Papasavvas; Jay R Kostman; Brian Thiel; Maxwell Pistilli; Agnieszka Mackiewicz; Andrea Foulkes; Robert Gross; Kimberly A Jordan; Douglas F Nixon; Robert Grant; Jean-Francois Poulin; Joseph M McCune; Karam Mounzer; Luis J Montaner Journal: J Clin Immunol Date: 2006-01 Impact factor: 8.542