Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/148339
Title: Plasma HIV Viral Rebound following Protocol-Indicated Cessation of ART Commenced in Primary and Chronic HIV Infection
Author: Hamlyn, Elizabeth
Ewings, Fiona M.
Porter, Kholoud
Cooper, David A.
Tambussi, Giuseppe
Schechter, Mauro
Pedersen, Court
Okulicz, Jason F.
McClure, Myra
Babiker, Abdel
Weber, Jonathan
Fidler, Sarah
Miró Meda, José M.
López-Diéguez, María
Manzardo, Christian
Arnaiz Gargallo, Juan Alberto
Pumarola Suñé, Tomás
Plana Prades, Montserrat
Tuset Creus, Montserrat
Ligero, M. C.
García, M. T.
Gallart, Teresa
Gatell, José M.
INSIGHT SMART
SPARTAC Trial Investigators
Keywords: Infeccions per VIH
Antiretrovirals
HIV infections
Antiretroviral agents
Issue Date: 31-Aug-2012
Publisher: Public Library of Science (PLoS)
Abstract: Objectives: The magnitude of HIV viral rebound following ART cessation has consequences for clinical outcome and onward transmission. We compared plasma viral load (pVL) rebound after stopping ART initiated in primary (PHI) and chronic HIV infection (CHI). Design: Two populations with protocol-indicated ART cessation from SPARTAC (PHI, n = 182) and SMART (CHI, n = 1450) trials. Methods: Time for pVL to reach pre-ART levels after stopping ART was assessed in PHI using survival analysis. Differences in pVL between PHI and CHI populations 4 weeks after stopping ART were examined using linear and logistic regression. Differences in pVL slopes up to 48 weeks were examined using linear mixed models and viral burden was estimated through a time-averaged area-under-pVL curve. CHI participants were categorised by nadir CD4 at ART stop. Results: Of 171 PHI participants, 71 (41.5%) rebounded to pre-ART pVL levels, at a median of 50 (95% CI 48-51) weeks after stopping ART. Four weeks after stopping treatment, although the proportion with pVL$400 copies/ml was similar (78% PHI versus 79% CHI), levels were 0.45 (95% CI 0.26-0.64) log10 copies/ml lower for PHI versus CHI, and remained lower up to 48 weeks. Lower CD4 nadir in CHI was associated with higher pVL after ART stop. Rebound for CHI participants with CD4 nadir .500 cells/mm3 was comparable to that experienced by PHI participants. Conclusions: Stopping ART initiated in PHI and CHI was associated with viral rebound to levels conferring increased transmission risk, although the level of rebound was significantly lower and sustained in PHI compared to CHI
Note: Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0043754
It is part of: PLoS One, 2012, vol. 7, num. 8, p. e43751
URI: http://hdl.handle.net/2445/148339
Related resource: https://doi.org/10.1371/journal.pone.0043754
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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