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Date Posted: 18:33:31 07/24/02 Wed
Author: moonotter
Subject: HIV-Specific Response Can Be Preserved With Short-Course ART During Primary Infection

HIV-Specific Response Can Be Preserved With Short-Course ART During Primary Infection


Reuters Health Information 2002. © 2002 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.


By Deborah Mitchell
BARCELONA, Spain (Reuters Health) Jul 09 - A short course of antiretroviral therapy in patients with primary HIV infection can prevent destruction of HIV-specific CD4 T-cell responses, UK researchers reported here on Tuesday at the XIV International AIDS Conference.

Dr. Sarah J. Fidler of the Imperial College Faculty of Medicine in London and colleagues hypothesized that a short course of ART (SCART) administered during early infection may be sufficient to preserve HIV-specific CD4+ T-helper responses that would otherwise be lost without intervention.

This approach may also benefit patients by avoiding toxicity from long-term therapy and development of drug resistance. It can also substantially reduce treatment costs, making it a potentially useful approach in resource-poor settings where long treatment is not possible, Dr. Fidler told conference attendees.

So far, Dr. Fidler's team has recruited approximately 60 patients with acute symptomatic HIV infection who were offered SCART. The median time from the development of symptoms to treatment was 30 days. Followup data were presented on 52 patients who opted for treatment and seven who declined.

The patients were evaluated monthly for CD4+ counts and plasma HIV load.

The length of SCART varied by patient, but after a median of 12 weeks, all of the treated patients had plasma HIV RNA loads below 50 copies/mL. Only a handful of patients had evidence of phenotypic drug resistance at baseline and none developed resistance mutations after SCART.

After approximately 48 weeks of followup, the majority of SCART patients had no evidence of HIV progression. In contrast, four of the seven patients who did not receive treatment had rapid disease progression; one was able to control viremia.

Overall, the majority of patients who received SCART during primary HIV infection showed a preservation of HIV-specific, CD4 T-helper responses, she told conference participants. The intervention was safe and generally well tolerated.

She noted, however, that primary HIV infection is "highly heterogeneous," and patients experience a wide range of virologic and immunologic responses. Therefore, large-scale randomized trials of SCART during primary HIV infection are warranted.



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