Rate of HIV-1 decline following antiretroviral therapy is related to viral load at baseline and drug regimen.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Rate of HIV-1 decline following antiretroviral therapy is related to viral load at baseline and drug regimen.

AIDS. 1998 Aug 20;12(12):1483-90. Unique Identifier : AIDSLINE MED/98394552
Notermans DW; Goudsmit J; Danner SA; de Wolf F; Perelson AS; Mittler J; Department of Human Retrovirology, University of Amsterdam, The; Netherlands.

Abstract: OBJECTIVES AND DESIGN: The dynamics uf viral decline following the initiation of antiretroviral treatment were studied in 29 HIV-1-infected patients participating in a two-arm trial comparing immediate (group A: ritonavir, zidovudine and lamivudine) and delayed (group B: ritonavir supplemented by zidovudine and lamivudine on day 21) triple therapy. Parameters underlying viral dynamics were estimated using mathematical models tailored to these treatment protocols. RESULTS: The decline in plasma HIV-1 density between day 0 and 21 was steeper in group A (-2.27+/- 0.46 log10) than group B (-1.87+/-0.56 log10). In a subset of patients amenable to full mathematical analysis, a short-lived productively infected cell compartment (producing approximately 97% of total virions) decayed with a half-life of 1.0-2.5 days, whereas a long-lived infected cell compartment decayed with a half-life of 18.8-32.8 days. Estimates for the time for the elimination of virus from these two cell populations ranged from 474 to 802 days. The rate of loss of productively infected CD4+ T cells was positively correlated with baseline viral load in group A and in the combined dataset. CONCLUSIONS: These results suggest that HIV-infected cell populations may have a faster turnover in patients with higher viral loads due to higher infection rate parameters, higher rates of virus production, or lower virus clearance rates.

Keywords: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL Anti-HIV Agents/*THERAPEUTIC USE CD4-Positive T-Lymphocytes Drug Therapy, Combination Human HIV Infections/*DRUG THERAPY HIV-1/*PHYSIOLOGY Lamivudine/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Models, Theoretical Ritonavir/ADMINISTRATION & DOSAGE/THERAPEUTIC USE RNA, Viral/ANALYSIS Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Treatment Outcome *Viral Load Zidovudine/ADMINISTRATION & DOSAGE/THERAPEUTIC USE
990130
A9911033

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