Treatment during primary HIV infection does not lower viral set point but improves CD4 lymphocytes in an observational cohort

European Journal of Medical Research

H Jaeger⁴  H Knechten⁶  A Goetzenich¹  J Goelz¹  M Rausch⁵  K Schewe²  H Jessen⁷  N Hanhoff¹  E Wolf³  C Koegl³ 

[1]DAGNAE e.V., Berlin, Germany

[2]IPM/ICH-Studycenter, Hamburg, Berlin

[3] Germany

[4]MUC Research, Munich, Germany

[5]MVZ Karlsplatz -HIV Research and Clinical Care Centre Munich, Munich, Germany

[6]Private Practice, Berlin

[7] Germany

[8]PZB Aachen, Germany

[9]HIV outpatient practice, Berlin, Germany

关键词: viral set point;    HIV;    antiretroviral therapy;    CD4 lymphocytes;    Primary HIV Infection;   

Others  :  1093692
DOI  :  10.1186/2047-783X-14-7-277

 received in 2008-12-17, accepted in 2009-06-02,  发布年份 2009

【 摘 要 】

Objective

To investigate if early treatment of primary HIV-1 infection (PHI) reduces viral set point and/or increases CD4 lymphocytes.

Methods

Analysis of two prospective multi-centre PHI cohorts. HIV-1 RNA and CD4 lymphocytes in patients with transient treatment were compared to those in untreated patients. Time to CD4 lymphocyte decrease below 350/μl after treatment stop or seroconversion was calculated using Kaplan-Meier and Cox-PH-regression analyses.

Results

156 cases of PHI were included, of which 100 had received transient HAART (median treatment time 9.5 months) and 56 remained untreated. Median viral load (563000 cop/ml vs 240000 cop/ml; p < 0.001) and median CD4 lymphocyte (449/μl vs. 613/μl; p < 0.01) differed significantly between treated and untreated patients. Median viral load was 38056 copies/ml in treated patients (12 months after treatment stop) and 52880 copies/ml in untreated patients (12 months after seroconversion; ns). Median CD4 lymphocyte change was +60/μl vs. -86/μl (p = 0.01). Median time until CD4 lymphocytes decreased to < 350/μl (including all patients with CD4 lymphocytes < 500/μl during seroconversion) was 20.7 months in treated patients after treatment stop and 8.3 months in untreated patents after seroconversion (p < 0.01). Cox-PH analyses adjusting for baseline VL, CD4 lymphocytes, stage of early infection and symptoms confirmed these differences.

Conclusions

Treatment during PHI did not lower viral set point. However, patients treated during seroconversion had an increase in CD4 lymphocytes, whereas untreated patients experienced a decrease in CD4 lymphocytes. Time until reaching CD4 lymphocytes < 350/μl was significantly shorter in untreated than in treated patients including patients with CD4 lymphocytes < 500/μl during seroconversion.

【 授权许可】

   
2009 I. Holzapfel Publishers

【 图 表 】

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