Important note: Information in this article was accurate in September 2004. The state of the art may have changed since the publication date.
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AIDSWEEKLY Plus; Monday, September 6, 2004
Staff Medical Writers
"To assess the clinical, immunological and virological evolution in HIV-1 infected patients with CD4 T-cell count above 500/mm3, a historical cohort of 202 untreated and 96 patients treated with HAART was longitudinally studied (median follow up 36 months)," wrote investigators in France.
"Fourteen untreated and 2 treated patients experienced clinical progression (p=.09). The difference between baseline CD4 T-cell count and after 3 years was -240/mm3 in the untreated group vs. +19/mm3 in the HAART group (P<10-3).
"A better immunological outcome was significantly associated with a HIV sexual contamination (p=.01), HAART (p=.01), high baseline CD4 T-cell count (P<10-3) and low baseline HIV viral load (p=.01)," L. Piroth and colleagues reported.
"In the HAART group," said researchers, "the incidence rate of antiretroviral modification due to tolerance difficulties was 0.23±0.36/patient year. A sustained undetectable HIV viral load was correlated with a low baseline HIV viral load (p=.003) and to be antiretroviral naive (P<103)."
Piroth concluded, "Thus, HAART provides a better immunological outcome in patients with high CD4 T-cell count. However, the CD4 decay slope after 3 years, the risk of therapeutic side-effects and the low risk of clinical progression do not support systematic treatment of those patients."
Piroth and colleagues published their study in European Journal of Epidemiology (Clinical, immunological and virological evolution in patients with CD4 T-cell count above 500/mm3): Is there a benefit to treat with highly active antiretroviral therapy (HAART)? Eur J Epidemiol. 2004;19(6):597-604.
For additional information, contact L. Piroth, Hopital Enfants, Service Malad Infection and Trop, F-21034 Dijon, France.
The publisher of the European Journal of Epidemiology can be contacted at: Kluwer Academic Publ, Van Godewijckstraat 30, 3311 Gz Dordrecht, Netherlands.
The information in this article comes under the major subject areas of Antiretroviral Therapy, Genomics and Genetics, Immunology, and Virology.
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
Piroth L, Binquet C, Buisson M, et al., "Clinical, immunological and virological evolution in patients with CD4 T-cell count above 500/mm3: is there a benefit to treat with highly active antiretroviral therapy (HAART)?", Eur J Epidemiol. 2004;19(6):597-604.
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