Full suppression of viral load is needed to achieve an optimal CD4 cell count response among patients on triple drug antiretroviral therapy
Full suppression of viral load is needed to achieve an optimal CD4 cell count response among patients on triple drug antiretroviral therapy
复制标题
DOI：
10.1097/00002030-200009080-00011
复制
发表时间：
2000-09-08
期刊：
影响因子：
3.8
通讯作者：
Montaner, JSG
中科院分区：
文献类型：
--
作者：
Wood, E;Yip, B;Montaner, JSG
目的：描述血浆病毒载量（pVL）抑制和三联抗逆转录病毒药物治疗之间的关系，以及伴随的CD 4细胞计数的变化。方法：回顾性研究的465名参与者在艾滋病毒/艾滋病治疗计划谁开始三联药物治疗之间的1996年8月和1998年5月。参与者根据他们的pVL反应分为三组：（ii）无反应者（NR; n = 112）在研究期间表现出pVL持续> 500拷贝/ml;（ii）部分应答者（PR; n = 100）至少一次达到pVL < 100拷贝/ml，随后反弹至> 500拷贝/ml;和（iii）完全应答者（FR; n = 253）达到pVL < 500拷贝/ml，并在研究期的剩余时间内维持该水平。结果：从基线到观察期结束，NR、PR和FR的pVL平均净变化分别为-0.37、-2.27和-2.56 log（10）拷贝/ml。在第68-83周期间，NR、PR和FR的中位CD 4细胞计数（x 106个细胞/l）分别为150 [四分位距（IQR）90-370]、380（IQR 300-480）和525（IQR 305-705）。NR、PR和FR的CD 4细胞（x 106个细胞/l）中位变化分别为-20（IQR -90至40）、150（IQR 30-250）和240（IQR 110-365）。NR、PR和FR的人均CD 4细胞净百分比变化分别为0% 9（IQR-34 - 31）、54%（IQR 6-160）和83%（IQR 39-173）。到第68-83周，NR、PR和FR的中位CD 4细胞分数分别为0.16（IQR 0.07-0.22）、0.22（IQR 0.15-0.28）和0.26（IQR 0.17-0.34）。我们的数据表明，最大限度地抑制病毒复制仍然是治疗的主要目标。(C)2000年利平科特威廉姆斯&威尔金斯。
Objective: To characterize the relationship between plasma viral load (pVL) suppression and triple drug antiretroviral therapy, and the accompanying changes in CD4 cell counts.Method: Retrospective study of 465 participants in a HIV/AIDS Treatment Program who initiated triple drug therapy between August 1996 and May 1998. Participants were divided into three groups according to their pVL response: (ii) non-responders (NR; n = 112) exhibited pVL persistently > 500 copies/mli over the study period; (ii) partial responders (PR; n = 100) achieved a pVL < 100 copies/ml at least once and subsequently rebounded to > 500 copies/ml; and (iii) full responders (FR; n = 253) achieved a pVL < 500 copies/ml and sustained this level for the remainder of the study period. For each group, the accompanying changes in absolute and fractional CD4 cell counts were evaluated.Results: The median net change in pVL per person from baseline to the end of the observation period was -0.37, -2.27, and -2.56 log(10) copies/ml for NR, PR acid FR, respectively. During weeks 68-83, the median CD4 cell count(x 10(6) cells/l) was 150 [interquartile range (IQR) 90-370], 380 (IQR 300-480) and 525 (IQR 305-705) for NR, PR and FR, respectively. Median changes in CD4 cells (x 106 cells/l) were -20 (IQR -90 to 40), 150 (IQR 30-250) and 240 (IQR 110-365) for NR, PR, and FR, respectively. The net percentage change in CD4 cells per person was 0% 9 (IQR -34-31), 54% (IQR 6-160), and 83% (IQR 39-173) for NR, PR, and FR, respectively. By weeks 68-83, the median fractional CD4 cells was 0.16 (IQR 0.07-0.22), 0.22 (IQR 0.15-0.28), and 0.26 (IQR 0.17-0.34) for NR, PR and FR respectively.Conclusions: An optimal CD4 cell count response appears to be coupled with continued pVL suppression. Our data indicate that maximal suppression of viral replication should remain the primary goal of therapy. (C) 2000 Lippincott Williams & Wilkins.