HIV-1 RNA response to antiretroviral treatment in 1280 participants in the Delta Trial:: an extended virology study

被引：25

作者：

Aboulker, JP ^{[1
]}

Babiker, AG ^{[1
]}

Brun-Vézinet, F ^{[1
]}

Darbyshire, JH ^{[1
]}

Flandre, P ^{[1
]}

Gazzard, B ^{[1
]}

Nunn, AJ ^{[1
]}

Goodall, R ^{[1
]}

Aber, V ^{[1
]}

Bragman, K ^{[1
]}

Breckenridge, AM ^{[1
]}

Carbon, C ^{[1
]}

Charreau, I ^{[1
]}

Chene, G ^{[1
]}

Collis, P ^{[1
]}

Cooper, D ^{[1
]}

Dormont, J ^{[1
]}

Fiddian, P ^{[1
]}

Flepp, M ^{[1
]}

Goebel, FD ^{[1
]}

Hooker, M ^{[1
]}

Lange, J ^{[1
]}

Lüthy, R ^{[1
]}

Peto, TEA ^{[1
]}

Reiss, P ^{[1
]}

Seligmann, M ^{[1
]}

Stone, AB ^{[1
]}

Thomis, J ^{[1
]}

Vella, S ^{[1
]}

Walckenaer, G ^{[1
]}

Warrell, D ^{[1
]}

Weller, IVD ^{[1
]}

Wilber, R ^{[1
]}

Yeni, P ^{[1
]}

Yeo, J ^{[1
]}

Withnall, R ^{[1
]}

Goudsmit, J ^{[1
]}

Huraux, JM ^{[1
]}

van der Noorda, J ^{[1
]}

Weiss, R ^{[1
]}

Boucher, C ^{[1
]}

Schuurman, R ^{[1
]}

Descamps, D ^{[1
]}

Jeffries, D ^{[1
]}

Tedder, R ^{[1
]}

Weber, J ^{[1
]}

Krzyanowski, C ^{[1
]}

Weverling, G ^{[1
]}

机构：

[1] UCL, Sch Med, Mortimer Market Ctr, MRC,Clin Trials Unit, London WC1E 6AU, England

来源：

AIDS | 1999年 / 13卷 / 01期

关键词：

antiviral therapy; progression; HIV-1; RNA; viral load;

D O I：

10.1097/00002030-199901140-00008

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To assess changes in HIV RNA and their relationship to disease progression. Design and setting: Delta was a randomized double-blind trial comparing zidovudine (ZDV) monotherapy with ZDV plus didanosine (ddl) or ZDV plus zalcitabine (ddC). Participants had AIDS (with CD4 cell counts above 50 x 10(6)/l), AIDS-related complex, or were asymptomatic with CD4 cell counts below 350 x 10(6)/l. The trial included both ZDV-naive and ZDV-experienced participants. Participants: A total of 1280 participants in the Delta trial whose serum samples had been stored at -70 degrees C and who had a minimum of one sample taken before the start of treatment and at least one later sample. Methods: HIV-1 RNA quantification was performed using the nucleic acid sequence-based amplification HIV-1 RNA quantitative assay with a cut-off of 800 copies/ml. Results: Reductions in HIV RNA by treatment group were consistent with the clinical results; in ZDV-naive participants the maximum median fall occurred at 4 weeks for all three groups (ZDV, 0.54 log(10) copies/ml; ZDV-ddl, 1.38 log(10) copies/ml; ZDV-ddC, 1.31 log(10), copies/ml). On average the reductions were smaller in ZDV-experienced participants but the difference between the monotherapy and combination arms was very similar in ZDV-naive and experienced participants. Baseline HIV RNA levels, adjusted for CD4 cell counts were highly predictive of time to virological response (HIV RNA < 800 copies/ml); HIV RNA nadirs achieved were predictive of survival. Viral load rebound following response was independent of treatment group and previous ZDV therapy. Conclusions: Virological changes in response to treatment are of Value in assessing prognosis and the activity of new therapies; in particular, there is a strong association between the minimum HIV RNA achieved in the first 16 weeks and subsequent clinical response. CD4 cell counts are independently predictive of response. (C) 1999 Lippincott Williams & Wilkins.

引用

页码：57 / 65

页数：9

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