Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.

BACKGROUND: National and international guidelines call for the treatment of primary HIV infection (PHI) with combination antiretroviral therapy, although the ideal timing and duration of this intervention is unknown. Recent immunological studies of antiretroviral therapy on small numbers of patient...

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Main Authors: Fidler, S, Oxenius, A, Brady, M, Clarke, J, Cropley, I, Babiker, A, Zhang, H, Price, D, Phillips, R, Weber, J
Format: Journal article
Language:English
Published: 2002
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author Fidler, S
Oxenius, A
Brady, M
Clarke, J
Cropley, I
Babiker, A
Zhang, H
Price, D
Phillips, R
Weber, J
author_facet Fidler, S
Oxenius, A
Brady, M
Clarke, J
Cropley, I
Babiker, A
Zhang, H
Price, D
Phillips, R
Weber, J
author_sort Fidler, S
collection OXFORD
description BACKGROUND: National and international guidelines call for the treatment of primary HIV infection (PHI) with combination antiretroviral therapy, although the ideal timing and duration of this intervention is unknown. Recent immunological studies of antiretroviral therapy on small numbers of patients with PHI have reported preservation of HIV-specific CD4 T-helper responses, ordinarily lost in the absence of intervention. We sought to investigate whether a short course of antiretroviral therapy (SCART) at PHI was sufficient to preserve HIV-specific cellular immunity. METHODS: Forty-five subjects with confirmed PHI were offered SCART at diagnosis. HIV specific cellular immune responses and virological parameters were assessed at monthly intervals. RESULTS: Thirty-seven of the subjects chose SCART at PHI, and achieved a plasma viral load < 50 RNA copies/ml by a median of 10 weeks (range, 4-32 weeks). Two of the 45 individuals had evidence of genotypic HIV drug resistance at baseline, and none developed new mutations following therapy. All patients who received SCART at PHI showed preservation of HIV-specific CD4 T-helper responses up to 64 weeks off SCART. CONCLUSION: SCART at PHI was safe, did not induce the development of drug resistance, and appeared sufficient to preserve HIV-specific CD4 T-helper responses. However, PHI is highly heterogeneous, and a large-scale randomized trial of SCART at PHI is now needed.
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spelling oxford-uuid:c7861f29-b96d-48bd-96fc-6794dc8fee452022-03-27T06:45:35ZVirological and immunological effects of short-course antiretroviral therapy in primary HIV infection.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c7861f29-b96d-48bd-96fc-6794dc8fee45EnglishSymplectic Elements at Oxford2002Fidler, SOxenius, ABrady, MClarke, JCropley, IBabiker, AZhang, HPrice, DPhillips, RWeber, J BACKGROUND: National and international guidelines call for the treatment of primary HIV infection (PHI) with combination antiretroviral therapy, although the ideal timing and duration of this intervention is unknown. Recent immunological studies of antiretroviral therapy on small numbers of patients with PHI have reported preservation of HIV-specific CD4 T-helper responses, ordinarily lost in the absence of intervention. We sought to investigate whether a short course of antiretroviral therapy (SCART) at PHI was sufficient to preserve HIV-specific cellular immunity. METHODS: Forty-five subjects with confirmed PHI were offered SCART at diagnosis. HIV specific cellular immune responses and virological parameters were assessed at monthly intervals. RESULTS: Thirty-seven of the subjects chose SCART at PHI, and achieved a plasma viral load < 50 RNA copies/ml by a median of 10 weeks (range, 4-32 weeks). Two of the 45 individuals had evidence of genotypic HIV drug resistance at baseline, and none developed new mutations following therapy. All patients who received SCART at PHI showed preservation of HIV-specific CD4 T-helper responses up to 64 weeks off SCART. CONCLUSION: SCART at PHI was safe, did not induce the development of drug resistance, and appeared sufficient to preserve HIV-specific CD4 T-helper responses. However, PHI is highly heterogeneous, and a large-scale randomized trial of SCART at PHI is now needed.
spellingShingle Fidler, S
Oxenius, A
Brady, M
Clarke, J
Cropley, I
Babiker, A
Zhang, H
Price, D
Phillips, R
Weber, J
Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title_full Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title_fullStr Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title_full_unstemmed Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title_short Virological and immunological effects of short-course antiretroviral therapy in primary HIV infection.
title_sort virological and immunological effects of short course antiretroviral therapy in primary hiv infection
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