Important note: Information in this article was accurate in October 2004. The state of the art may have changed since the publication date.
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AIDSWEEKLY Plus; Monday, October 11, 2004
Staff Medical Writers
"The aim of the study was to investigate the safety and efficacy of a salvage therapy initiated after interrupting treatment in patients with virological failure and more than 200 CD4+ T lymphocyte count.
"In this prospective study, 77 patients who received failing regimens had stopped completely all medication for 3 months before starting an optimized regimen consisting of 3-5 drugs. Patients were tested for HIV resistance before and after treatment interruption," wrote investigators in France.
"Discontinuation of therapy for 3 months was associated with a median increase in HIV RNA of 1.1 log10, a median decrease in CD4+ T cell count of 136x106/L and five clinical events related to HIV, but no AIDS-defining event. Eighty-seven percent of patients showed a shift from a drug resistant genotype to a wild-type genotype based on the major resistance mutations," A. Jaafar and colleagues reported.
"Forty-seven percent of patients with a genotype shift reached fewer than 200 HIV RNA copies/ml of plasma 6 and 12 months after treatment resumption whereas none of those without a genotype shift did so (P=0.03).
"However," said the authors, "the genotypic shift was not associated with a sustained virological response by multivariate analysis. The use of a new therapeutic class of compound in the salvage regimen was the only predictor of the sustained virological response."
"Salvage therapy with 3-5 drugs after interrupting treatment for 3 months can be a safe and effective strategy provided the HIV disease is not too advanced. Randomized trials in this population are needed to assess the clinical benefit of this strategy," Jaafar concluded.
Jaafar and colleagues published the results of their research in Journal of Medical Virology (HIV therapy after treatment interruption in patients with multiple failure and more than 200 CD4+ T lymphocyte count. J Med Virol. 2004 Sep;74(1):8-15.
For additional information, contact J. Izopet, CHU Toulouse, Virology Laboratory, Hopital Purpan, Pl Docteur Baylor, TSA 40031, F-31059 Toulouse 9, France.
The publisher of the Journal of Medical Virology can be contacted at: Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030 USA.
The information in this article comes under the major subject areas of HIV/AIDS, Antiretroviral Therapy, Salvage Therapy, and Drug Resistance.
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
Jaafar A, Massip P, Sandres-Saune K, et al., "HIV therapy after treatment interruption in patients with multiple failure and more than 200 CD4+ T lymphocyte count", J Med Virol. 2004 Sep;74(1):8-15.
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