Linked Life Data

11064501

Source:http://linkedlifedata.com/resource/pubmed/id/11064501

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2000-12-13
pubmed:abstractText
The objective of antiretroviral therapy is to obtain an almost complete and durable suppression of viral replication in all compartments to facilitate recovery of the immune system. We assessed the virologic effect in plasma, tonsillar tissue, and cerebrospinal fluid (CSF) in 94 HIV-1-infected patients with CD4 counts >500 x 106 cells per liter and viral load >5000 copies/ml randomly assigned to triple antiretroviral therapy (two nucleoside reverse transcriptase inhibitors (NRTIs) plus one protease inhibitor) versus double therapy (two NRTIs). We also analyzed the immunologic recovery in this cohort of patients. Lymphoid tissue and cerebrospinal fluid viral load, development of genotypic resistance, proliferative responses to HIV-1 specific antigens, and other immunophenotypic markers were analyzed. The proportion of patients who achieved a decrease in HIV RNA levels to <200 copies/ml was significantly greater in the triple therapy group than in the two drug groups (p =.0002 for each pair-wise difference). At week 52, tonsillar tissue HIV RNA from 5 patients treated with triple therapy was lower than the limit of detection, whereas the mean +/- standard error in patients with double therapy (n = 5) was 5.03 +/- 0.34 copies/mg/tissue. In all 10 patients, CSF viral load (VL) was <20 HIV-1 RNA copies/ml at week 52. CSF cell counts and protein levels tended to decrease after 52 weeks of antiretroviral therapy. After 1 year of therapy, 13 of 21 patients (62%) in the double-therapy groups (zidovudine plus lamivudine [n = 9] and stavudine plus lamivudine [n = 12]) had evidence of M184V mutation. None of the 10 samples of patients receiving triple therapy could be amplified because of low HIV RNA levels. The mean increase in CD4 cells at week 52 was greater in the stavudine and lamivudine and indinavir group than in the double-treatment arms (186 versus 67 and 102, respectively; p =.03). In patients treated with triple therapy, the increase in naive T cells (CD4 and CD8) was greater than in patients treated with double therapy. Markers of activation decreased further in patients treated with the regimen that included protease inhibitors. Proliferative responses to HIV-1 p24 antigen were never recovered after double or triple therapy. Our study suggests that even in very early stages of HIV-1 disease only therapy with two NRTIs and one protease inhibitor reduces plasma, lymphoid tissue, and CSF VL to undetectable levels. HIV-1-related immune system abnormalities improved but were still defective after 1 year of antiretroviral therapy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
1525-4135
pubmed:author
pubmed:issnType
Print
pubmed:day
1
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
26-35
pubmed:dateRevised
2008-11-21
pubmed:meshHeading
pubmed-meshheading:11064501-Adult, pubmed-meshheading:11064501-Blood, pubmed-meshheading:11064501-CD4 Lymphocyte Count, pubmed-meshheading:11064501-Cell Count, pubmed-meshheading:11064501-Cerebrospinal Fluid, pubmed-meshheading:11064501-Cerebrospinal Fluid Proteins, pubmed-meshheading:11064501-Cohort Studies, pubmed-meshheading:11064501-Drug Therapy, Combination, pubmed-meshheading:11064501-Female, pubmed-meshheading:11064501-HIV Infections, pubmed-meshheading:11064501-HIV Protease Inhibitors, pubmed-meshheading:11064501-HIV-1, pubmed-meshheading:11064501-Humans, pubmed-meshheading:11064501-Lamivudine, pubmed-meshheading:11064501-Male, pubmed-meshheading:11064501-Palatine Tonsil, pubmed-meshheading:11064501-Point Mutation, pubmed-meshheading:11064501-RNA, Viral, pubmed-meshheading:11064501-Reverse Transcriptase Inhibitors, pubmed-meshheading:11064501-Spain, pubmed-meshheading:11064501-Stavudine, pubmed-meshheading:11064501-Time Factors, pubmed-meshheading:11064501-Viral Load, pubmed-meshheading:11064501-Zidovudine
pubmed:year
2000
pubmed:articleTitle
Comparison of immunologic restoration and virologic response in plasma, tonsillar tissue, and cerebrospinal fluid in HIV-1-infected patients treated with double versus triple antiretroviral therapy in very early stages: The Spanish EARTH-2 Study. Early Anti-Retroviral Therapy Study.
pubmed:affiliation
Infectious Diseases Unit and Microbiology and Immunology Laboratories, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clínic, Faculty of Medicine, University of Barcelona, Barcelona, Spain. ggarcia@medicina.ub.es
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't