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Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Plasma HIV Load and Proviral DNA Decreases After Two Standard Antiretroviral Regimens in HIV-Positive Patients Naive to Antiretrovirals

Author(s): Carlo Torti, Maria Eugenia Quiros-Roldan, Giuliana Cologni, Michele Nichelatti, Francesca Ceresoli, Marcello Pinti, Milena Nasi, Andrea Cossarizza, Giuseppe Lapadula, Silvia Costarelli, Nino Manca, Franco Gargiulo, Michele Magoni and Giampiero Carosi

Volume 6, Issue 1, 2008

Page: [43 - 48] Pages: 6

DOI: 10.2174/157016208783571982

Price: $65

Abstract

(i) To compare early decrease of HIV plasma viral load (pVL) after two standard combinations of highly active antiretroviral therapy (HAART). (ii) To evaluate variations of proviral HIV-DNA load on conditions of sustained pVL undetectability. Two different sub-studies of a multicentre prospective randomized controlled trial which compared two first-line HAART (i.e., zidovudine+lamivudine+lopinavir/ritonavir versus tenofovir+lamivudine+ efavirenz). Only patients enrolled at the coordinating centre (University of Brescia) were included in the two sub-studies. In the first substudy, we calculated pVL decrease with respect to baseline at any of the following time-points: days 1, 3, 7, 14 and 28. Decreases of the pVL were compared between the two treatment groups. In the second sub-study, we analyzed variation of proviral HIV-DNA load in CD4+ T-cells from baseline to week 52 only in patients who maintained the same treatment regimen and had sustained undetectable pVL. In either studies, linear regression analysis was used to investigate what factors could influence variations of pVL and of proviral HIV-DNA load. (i) 64 patients were studied. A significant decrease of pVL was found from day 3 on, without statistically significant differences between the two study groups. However, after adjusting for possible confounders, tenofovir+lamivudine+efavirenz resulted to be associated with greater pVL decreases. (ii) 45 patients were studied. Mean proviral HIV-DNA load decreased from 1,610 (95%CI: 879-2,341) to 896 (95% CI 499-1,293) copies/106 cells (P=0.05). Linear regression analysis showed that the decrease of proviral DNA load during follow-up was independently and inversely correlated with age. Further studies are needed to compare pVL decay between antiretroviral regimens and assess whether proviral HIV-DNA load is a surrogate marker of treatment effectiveness.

Keywords: Antiretroviral therapy, plasma viral load, proviral HIV-DNA, boosted protease inhibitors, non nucleoside reverse transcriptase inhibitors


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