OBJECTIVES: To compare immunological, virological and clinical outcomes in persons initiating combination antiretroviral therapy (cART of different durations within 6 months of seroconversion (early treated) with those who deferred therapy (deferred group). DESIGN: CD4 cell and HIV-RNA measurements for 'early treated' individuals following treatment cessation were compared with the corresponding ART-free period for the 'deferred' group using piecewise linear mixed models. Individuals identified during primary HIV infection were included if they seroconverted from 1st January 1996 and were at least 15 years of age at seroconversion. Those with at least 2 CD4 less than 350 cells/microl or AIDS within the first 6 months following seroconversion were excluded. RESULTS: Of 348 'early treated' patients, 147 stopped cART following treatment for at least 6 (n = 38), more than 6-12 (n = 40) or more than 12 months (n = 69). CD4 cell loss was steeper for the first 6 months following cART cessation, but subsequent loss rate was similar to the 'deferred' group (n = 675, P = 0.26). Although those treated for more than 12 months appeared to maintain higher CD4 cell counts following cART cessation, those treated for 12 months or less had CD4 cell counts 6 months after cessation comparable to those in the 'deferred' group. There was no difference in HIV-RNA set points between the 'early' and 'deferred' groups (P = 0.57). AIDS rates were similar but death rates, mainly due to non-AIDS causes, were higher in the 'deferred' group (P = 0.05). CONCLUSION: Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months. Its long-term effects remain inconclusive and need further investigation.
OBJECTIVES: To compare immunological, virological and clinical outcomes in persons initiating combination antiretroviral therapy (cART of different durations within 6 months of seroconversion (early treated) with those who deferred therapy (deferred group). DESIGN:CD4 cell and HIV-RNA measurements for 'early treated' individuals following treatment cessation were compared with the corresponding ART-free period for the 'deferred' group using piecewise linear mixed models. Individuals identified during primary HIV infection were included if they seroconverted from 1st January 1996 and were at least 15 years of age at seroconversion. Those with at least 2 CD4 less than 350 cells/microl or AIDS within the first 6 months following seroconversion were excluded. RESULTS: Of 348 'early treated' patients, 147 stopped cART following treatment for at least 6 (n = 38), more than 6-12 (n = 40) or more than 12 months (n = 69). CD4 cell loss was steeper for the first 6 months following cART cessation, but subsequent loss rate was similar to the 'deferred' group (n = 675, P = 0.26). Although those treated for more than 12 months appeared to maintain higher CD4 cell counts following cART cessation, those treated for 12 months or less had CD4 cell counts 6 months after cessation comparable to those in the 'deferred' group. There was no difference in HIV-RNA set points between the 'early' and 'deferred' groups (P = 0.57). AIDS rates were similar but death rates, mainly due to non-AIDS causes, were higher in the 'deferred' group (P = 0.05). CONCLUSION: Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months. Its long-term effects remain inconclusive and need further investigation.
Authors: Christine M Hogan; Victor Degruttola; Xin Sun; Susan A Fiscus; Carlos Del Rio; C Bradley Hare; Martin Markowitz; Elizabeth Connick; Bernard Macatangay; Karen T Tashima; Beatrice Kallungal; Rob Camp; Tia Morton; Eric S Daar; Susan Little Journal: J Infect Dis Date: 2011-12-15 Impact factor: 5.226
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Authors: Samuel R Friedman; Martin J Downing; Pavlo Smyrnov; Georgios Nikolopoulos; John A Schneider; Britt Livak; Gkikas Magiorkinis; Liudmyla Slobodianyk; Tetyana I Vasylyeva; Dimitrios Paraskevis; Mina Psichogiou; Vana Sypsa; Melpomeni M Malliori; Angelos Hatzakis Journal: AIDS Behav Date: 2014-10
Authors: Simone Pensieroso; Alberto Cagigi; Paolo Palma; Anna Nilsson; Claudia Capponi; Elio Freda; Stefania Bernardi; Rigmor Thorstensson; Francesca Chiodi; Paolo Rossi Journal: Proc Natl Acad Sci U S A Date: 2009-04-27 Impact factor: 11.205
Authors: C Koegl; E Wolf; N Hanhoff; H Jessen; K Schewe; M Rausch; J Goelz; A Goetzenich; H Knechten; H Jaeger; W Becker; I Becker-Boost; D Berzow; B Beiniek; J Brust; D Shcuster; S Dupke; S Fenske; H J Gellermann; R Gippert; P Hartmann; B Hintsche; H Jaeger; E Jaegel-Guedes; H Jessen; J Gölz; J Koelzsch; E B Helm; G Knecht; H Knechten; I Lochet; P Gute; S Mauruschat; S Mauss; V Miasnikov; F A Mosthaf; M Rausch; M Freiwald; B Reuter; H M Schalk; B Schappert; E Schnaitmann; I Schneider; W Schüler-Maué; C Schuler; T Seidel; W Starke; A Ulmer; M Müller; I Weitner; K Schewe; C Zamani; A Hanmond; K Ross; A Bottlaender; C Hoffmann; A Dix; A Schneidewind; M Lademann Journal: Eur J Med Res Date: 2009-07-22 Impact factor: 2.175
Authors: Viktor von Wyl; Sara Gianella; Marek Fischer; Barbara Niederoest; Herbert Kuster; Manuel Battegay; Enos Bernasconi; Matthias Cavassini; Andri Rauch; Bernard Hirschel; Pietro Vernazza; Rainer Weber; Beda Joos; Huldrych F Günthard Journal: PLoS One Date: 2011-11-15 Impact factor: 3.240