PMID- 15622314
OWN - NLM
STAT- MEDLINE
DCOM- 20050203
LR  - 20191210
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 18
IP  - 18
DP  - 2004 Dec 3
TI  - CD4+ cell-count-guided treatment interruptions in chronic HIV-infected patients 
      with good response to highly active antiretroviral therapy.
PG  - 2381-9
AB  - OBJECTIVE: To evaluate the safety of treatment interruption guided by CD4+ cell 
      count in HIV-infected patients followed up prospectively. METHODS: Patients on 
      highly active antiretroviral therapy with CD4+ cell counts > 500 x 10(6) cells/l 
      discontinued therapy with instructions to start therapy again before their CD4+ 
      count dropped below 200 x 10(6) cells/l. Any patients who resumed therapy would 
      be eligible to interrupt treatment again once their CD4+ cell count increased 
      above 500 x 10(6) cells/l. RESULTS: Data on 71 HIV infected patients is reported. 
      Their median nadir CD4+ cell count before antiretroviral treatment was 352 x 
      10(6) cells/l [interquartile range (IQR), 294-445 x 10(6) cells/l]. The median 
      CD4+ cell count at the time of first interruption was 790 x 10(6) cells/l (IQR, 
      657-1041 x 10(6) cells/l). The median follow-up after starting the first 
      treatment interruption was 28.3 months (IQR, 21.4-37.0 months). During the 
      follow-up 49 patients restarted therapy and 22 patients remain off therapy; 24 
      patients have interrupted therapy twice, nine patients have interrupted therapy 
      three times and six patients four times. No AIDS-defining illnesses occurred 
      during the follow-up. The median duration of the first interruption was 15 months 
      (IQR, 6-26 months). The overall reduction of time on therapy was 71.1%. The 
      duration of the first interruption and the reduction of time on therapy were 
      related to nadir CD4+ cell count. The patients who resumed HAART rapidly regained 
      CD4+ cells and achieved viral suppression. CONCLUSION: If carefully monitored, 
      treatment interruptions guided by CD4+ cell count in patients with an initially 
      high CD4+ cell counts are clinically safe, decrease exposure to the drugs and do 
      not reduce the efficacy of therapy when this is re-started.
FAU - Boschi, Andrea
AU  - Boschi A
AD  - Division of Infectious Diseases AUSL Rimini, Via Settembrini 2, 49300 Rimini 
      (RN), Italy. boschia@libero.it
FAU - Tinelli, Carmine
AU  - Tinelli C
FAU - Ortolani, Patrizia
AU  - Ortolani P
FAU - Moscatelli, Gianluigi
AU  - Moscatelli G
FAU - Morigi, Giorgio
AU  - Morigi G
FAU - Arlotti, Massimo
AU  - Arlotti M
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
SB  - IM
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Female
MH  - HIV Infections/*drug therapy/immunology
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Viral Load
MH  - *Withholding Treatment
EDAT- 2004/12/29 09:00
MHDA- 2005/02/04 09:00
CRDT- 2004/12/29 09:00
PHST- 2004/12/29 09:00 [pubmed]
PHST- 2005/02/04 09:00 [medline]
PHST- 2004/12/29 09:00 [entrez]
AID - 00002030-200412030-00005 [pii]
PST - ppublish
SO  - AIDS. 2004 Dec 3;18(18):2381-9.