AIDSWEEKLY Plus; Monday, October 19, 1998
Daniel J. DeNoon, Senior Editor
The measure used by most HIV clinicians to evaluate the efficacy of antiretroviral drugs gives an incomplete picture, a cohort study suggests.
Instead, the amount by which treatment decreases viral load appears to be the factor best associated with treatment success.
"At least a 3 log viral-load drop is needed to prevent continuous loss of CD4 cells," said Andrew N. Phillips of the Royal Free Center for HIV Medicine, London, U.K.
Phillips announced the findings during his plenary presentation to the American Society for Microbiology's 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held September 24- 27, 1998, in San Diego, California.
The study involved very frequent measures of viral load in HIV infected patients being followed during highly active antiretroviral therapy (HAART) at the Frankfurt, Germany, HIV Clinic. Researchers obtained four viral load counts each week.
They found that in terms of CD4 rebound during treatment, the amount of a patient's viral load drop was more significant than the patient's absolute viral load.
Patients with low CD4 counts at the time they began treatment tended to have shorter times during which their viral load became undetectable during treatment. The rate of viral rebound was associated with the degree of CD4 rebound.
Phillips suggested more frequent CD4 T-cell monitoring in patients with low CD4 counts. He also suggested that clinicians consider intensification of therapy in patients with low CD4 counts.
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