Rate of HIV-1 decline following antiretroviral therapy is related to viral load at baseline and drug regimen
Rate of HIV-1 decline following antiretroviral therapy is related to viral load at baseline and drug regimen
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DOI：
10.1097/00002030-199812000-00010
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发表时间：
1998-08-20
期刊：
影响因子：
3.8
通讯作者：
Mittler, J
中科院分区：
文献类型：
--
作者：
Notermans, DW;Goudsmit, J;Mittler, J
目的和设计：研究了29名hiv - 1感染患者开始抗逆转录病毒治疗后病毒下降的动态，这些患者参加了一项两臂试验，比较了立即（a组：利托那韦、齐多夫定和拉米夫定）和延迟（B组：利托那韦在第21天补充齐多夫定和拉米夫定）三联治疗。利用针对这些治疗方案量身定制的数学模型估计了病毒动力学的基本参数。结果：第0 ~ 21天，A组血浆HIV-1密度下降幅度（-2.27 +/- 0.46 log(10)）大于B组（-1.87 +/- 0.56 log(10)）。在一组可以进行完全数学分析的患者中，一个短寿命的生产性感染细胞区室（产生类似于总病毒粒子的97%）的半衰期为1.0-2.5天，而一个长寿命的感染细胞区室的半衰期为18.8-32.8天。从这两个细胞群中消除病毒的估计时间为474至802天。在A组和联合数据集中，有效感染CD4+ T细胞的损失率与基线病毒载量呈正相关。结论：这些结果表明，由于较高的感染率参数、较高的病毒产生率或较低的病毒清除率，hiv感染的细胞群在病毒载量较高的患者中可能有更快的更新。(C) 1998 Lippincott-Raven出版社。
Objectives and design: The dynamics of viral decline following the initiation of antiretroviral treatment were studied in 29 HIV-l-infected patients participating in a two-arm trial comparing immediate (group A: ritonavir, zidovudine and lamivudine) and delayed (group B: ritonavir supplemented by zidovudine and lamivudine on day 21) triple therapy. Parameters underlying viral dynamics were estimated using mathematical models tailored to these treatment protocols.Results: The decline in plasma HIV-1 density between day 0 and 21 was steeper in group A (-2.27 +/- 0.46 log(10)) than group B (-1.87 +/- 0.56 log(10)). In a subset of patients amenable to full mathematical analysis, a short-lived productively infected cell compartment (producing similar to 97% of total virions) decayed with a half-life of 1.0-2.5 days, whereas a long-lived infected cell compartment decayed with a half-life of 18.8-32.8 days. Estimates for the time for the elimination of virus from these two cell populations ranged from 474 to 802 days. The rate of loss of productively infected CD4+ T cells was positively correlated with baseline viral load in group A and in the combined dataset.Conclusions: These results suggest that HIV-infected cell populations may have a faster turnover in patients with higher viral loads due to higher infection rate parameters, higher rates of virus production, or lower virus clearance rates. (C) 1998 Lippincott-Raven Publishers.