TITLE

Residual viraemia does not influence 1 year virological rebound in HIV-infected patients with HIV RNA persistently below 50 copies/mL

AUTHOR(S)
Gianotti, Nicola; Galli, Laura; Racca, Sara; Salpietro, Stefania; Cossarini, Francesca; Spagnuolo, Vincenzo; Barda, Beatrice; Canducci, Filippo; Clementi, Massimo; Lazzarin, Adriano; Castagna, Antonella
PUB. DATE
January 2012
SOURCE
Journal of Antimicrobial Chemotherapy (JAC);Jan2012, Vol. 67 Issue 1, p213
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives It is currently debated whether patients with residual viraemia are at higher risk of virological failure than those attaining <1 HIV RNA copy/mL. We therefore investigated the effect of residual viraemia on virological rebound. Methods We used a prospective, non-interventional, single-centre, study. This analysis was based on HIV-infected patients with two consecutive HIV RNA viral loads (VLs) of <50 copies/mL as tested by Versant bDNA, followed by two HIV RNA VLs of <50 copies/mL as tested using the Versant kinetic PCR molecular system (kPCR; limit of quantification = 1 copy/mL). Virological rebound was defined as two consecutive HIV RNA values of >50 copies/mL after baseline, and the time to virological rebound was calculated using the Kaplan–Meier method. Results There were 739 eligible patients; 446 (60.4%) had HIV RNA <1 copy/mL (group A) and 293 (39.6%) had residual viraemia (1–49 HIV RNA copies/mL; group B). After a follow-up (median 48.9 weeks), virological rebound occurred in four patients in group A (0.9%) and six patients in group B (2%); the time to virological rebound was similar in the two groups (log-rank test P = 0.231). CD4+ cell recovery (slope) was significantly less in the patients with residual viraemia; +14.3 (−7.7, 43.9) cells/mm3 per year versus +21.2 (−2.5, 53.2) cells/mm3 per year; P = 0.036. Conclusions Residual viraemia assessed by kPCR was not associated with virological rebound during 1 year of follow-up. However, the patients attaining <1 HIV RNA copy/mL showed a small but statistically significant improvement in CD4+ cell recovery.
ACCESSION #
69709340

 

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