The effect of antiretroviral treatment of different durations in primary HIV infection
AIDSPublished 13 November 2008
Nikos Pantazis, Giota Touloumi, Philippe Vanhems, M. John Gill, Heiner C. Bucher, Kholoud Porter
Citations32
SJR quartileQ1
SJR score1.21
SNIP0.90
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months.
Abstract
Transient cART, initiated within 6 months of seroconversion, seems to have no effect on viral load set point and limited beneficial effect on CD4 cell levels in individuals treated for more than 12 months. Its long-term effects remain inconclusive and need further investigation.
Keywords
Immunology and MicrobiologyMedicine
Annals of Internal MedicineGuidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents
5,233 Citations1998
Annals of Internal MedicineAdherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection
3,328 Citations2000David L. Paterson, Susan Swindells +6 more
Given the critical importance of adherence to therapy to patient outcome, secondary prevention of HIV infection, and willingness of providers to prescribe therapy, this prospectively investigated the association between protease inhibitor adherence and patient outcome and factors related to adherence.
AIDSA syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors
2,397 Citations1998Andrew Carr, Katherine Samaras +5 more
A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance is a common complication of HIV protease inhibitors and diabetes mellitus is relatively uncommon.
New England Journal of MedicineTreatment with Indinavir, Zidovudine, and Lamivudine in Adults with Human Immunodeficiency Virus Infection and Prior Antiretroviral Therapy
1,900 Citations1997Roy M. Gulick, John W. Mellors +14 more
In most HIV-infected patients with prior antiretroviral therapy, the combination of indinavir, zidovudine, and lamivudine reduces levels of HIV RNA to less than 500 copies per milliliter for as long as one year.
ScienceVigorous HIV-1-Specific CD4 <sup>+</sup> T Cell Responses Associated with Control of Viremia
1,842 Citations1997Eric Rosenberg, James M. Billingsley +5 more
In individuals who control viremia in the absence of antiviral therapy, polyclonal, persistent, and vigorous HIV-1-specific CD4+ T cell proliferative responses were present, resulting in the elaboration of interferon-gamma and antiviral beta chemokines.
NatureImmune control of HIV-1 after early treatment of acute infection
998 Citations2000Eric Rosenberg, Marcus Altfeld +8 more
It is shown that, despite rebound in viraemia, all subjects were able to achieve at least a transient steady state off therapy with viral load below 5,000 RNA copies per ml, suggesting that functional immune responses can be augmented in a chronic viral infection.
The LancetRandomised placebo-controlled trial of ritonavir in advanced HIV-1 disease
540 Citations1998D. William Cameron, Margo Heath‐Chiozzi +9 more
Although earlier intervention with combination therapy may provide much more effective treatment, ritonavir in patients with advanced disease and extensive previous antiretroviral use is safe and effective, lowers the risk of AIDS complications, and prolongs survival.
Archives of Internal MedicineEffects of Protease Inhibitors on Hyperglycemia, Hyperlipidemia, and Lipodystrophy
455 Citations2000Sotirios Tsiodras, Christos S. Mantzoros +2 more
An independent association between PI use and hyperglycemia, hyperlipidemia, and lipodystrophy is found that is not explained by the antiviral and therapeutic effect of PIs.
New England Journal of MedicineTime to Hit HIV, Early and Hard
431 Citations1995David D. Ho
Early treatment of asymptomatic human immunodeficiency virus type 1 (HIV-1) infection remains controversial.
Proceedings of the National Academy of SciencesEarly highly active antiretroviral therapy for acute HIV-1 infection preserves immune function of CD8 <sup>+</sup> and CD4 <sup>+</sup> T lymphocytes
386 Citations2000Annette Oxenius, David A. Price +7 more
It is demonstrated that early use of HAART during primary infection preserves HIV-specific CD8(+) T cells physically and functionally while HIV- Specific T cell help is sustained, implying that HIV- specific T help is damaged during primary HIV-1 infection.
The Journal of Experimental MedicineCellular Immune Responses and Viral Diversity in Individuals Treated during Acute and Early HIV-1 Infection
385 Citations2001Marcus Altfeld, Eric Rosenberg +16 more
Examination of virus-specific cytotoxic T lymphocytes, T helper cells, and viral genetic diversity in relation to duration of infection and subsequent response to antiviral therapy concludes that early treatment of acute HIV infection leads to a more narrowly directed CTL response, stronger T helper cell responses, and a less diverse virus population.
AIDSFat distribution evaluated by computed tomography and metabolic abnormalities in patients undergoing antiretroviral therapy: preliminary results of the LIPOCO* study
360 Citations2000T Saint-Marc, M Partisani +7 more
These preliminary results suggest that three major types of fat distribution abnormalities may occur in isolation or in association in HIV-infected patients undergoing active antiretroviral therapy: a fat depletion or `lipoatrophy' syndrome which might be related to the use of stavudine; a mixed or fat redistribution syndrome related to an unusual side-product of effective virus control; and a subcutaneous adiposity syndrome reflecting increase in caloric intake.
The Journal of Infectious DiseasesNatural History of Human Immunodeficiency Virus Type 1 Viremia after Seroconversion and Proximal to AIDS in a Large Cohort of Homosexual Men
356 Citations2000Robert H. Lyles, Álvaro Muñoz +7 more
HIV RNA load at the first HIV-seropositive visit ( approximately 3 months after seroconversion) was highly predictive of AIDS, and subsequent HIV RNA measurements showed even better prognostic discrimination.
Statistics in MedicineThe need for randomization in the study of intended effects
278 Citations1983Olli S. Miettinen
The need for randomization as a means of controlling confounders is accentuated in the study of intended effects (efficacy) as compared with unintended ones (toxicity), because the indication for intervention is inherently a confounder in theStudy of efficacy but not of toxicity.
The Journal of Infectious DiseasesThe Effect of Commencing Combination Antiretroviral Therapy Soon after Human Immunodeficiency Virus Type 1 Infection on Viral Replication and Antiviral Immune Responses
182 Citations1999Martin Markowitz, Mika Vesanen +15 more
The persistence of HIV-1 RNA expression in lymphoid tissues and peripheral blood mononuclear cells suggests that elimination of this residual pool of virus should be achieved before considering adjustments in antiretroviral therapeutic regimens.
The Journal of Infectious DiseasesA Multicenter Observational Study of the Potential Benefits of Initiating Combination Antiretroviral Therapy during Acute HIV Infection
172 Citations2006Frederick Hecht, Lei Wang +9 more
Initiation of HAART within 2 weeks of antibody seroconversion was associated with viral load and CD4+ T cell count benefits for 24 weeks after termination ofHAART, with there being trends toward a longer-term benefit.
PubMedWhy is highly active antiretroviral therapy (HAART) not prescribed or discontinued? Swiss HIV Cohort Study.
160 Citations1999Stefano Bassetti, M Battegay +8 more
Multivariate logistic regression analysis indicated that patients with lower education, active intravenous drug users outside of a drug substitution program, and those who acquired HIV infection through IV drug use had a significantly higher risk of inadequate treatment.
The Journal of Infectious DiseasesDiscontinuation of Antiretroviral Therapy Commenced Early during the Course of Human Immunodeficiency Virus Type 1 Infection, with or without Adjunctive Vaccination
139 Citations2002Martin Markowitz, Xia Jin +14 more
Given the transient suppression of viremia observed in nearly all subjects after treatment has been discontinued, further investigations of adjunctive vaccination with optimized antiretroviral therapy in treating HIV-1 infection are warranted.
The Journal of Infectious DiseasesTreatment of Primary Human Immunodeficiency Virus Type 1 Infection with Potent Antiretroviral Therapy Reduces Frequency of Rapid Progression to AIDS
113 Citations2001M. Michelle Berrey, Timothy W. Schacker +10 more
Combination antiretroviral therapy during primary HIV-1 infection demonstrated a decreased frequency of minor opportunistic infections, mucocutaneous disorders, and respiratory infections and reduced progression to AIDS.
AIDSIs antiretroviral treatment of primary HIV infection clinically justified on the basis of current evidence?
99 Citations2004Don Smith, Bruce D. Walker +3 more
Although recent guidelines have suggested delaying treatment in persons with chronic infection, the same guidelines suggest that persons identified in acute infection may differ from other HIV-infected patients, and form a group where immediate treatment could be considered.
HIV MedicineChanges in the uptake of antiretroviral therapy and survival in people with known duration of HIV infection in Europe: results from CASCADE
89 Citations2000
The times from HIV seroconversion to death, and to the initiation of therapy and the mean CD4 cell count at initiation are estimated to be the same as for hepatitis B and C.
AIDSTime of initiation of antiretroviral therapy: impact on HIV-1 viraemia
86 Citations2000Sabine Yerly, Laurent Kaiser +7 more
Viraemia levels are associated with clinical progression and predict virological treatment failure, and the initiation of antiretroviral therapy at the time of PHI and while CD4 cell counts are high results in lower residual viraemia.
The Journal of Infectious DiseasesHighly Active Antiretroviral Treatment Initiated Early in the Course of Symptomatic Primary HIV‐1 Infection: Results of the ANRS 053 Trial
76 Citations1999Bruno Hoen, Béatrice Dumon +11 more
Highly active antiretroviral treatment was given early to 64 patients with symptomatic primary human immunodeficiency virus (HIV)-1 infection and preliminary results support the use of HAART in patients with primary HIV-1 infection.
PubMedDoes transient HAART during primary HIV-1 infection lower the virological set-point?
62 Citations2004Loïc Desquilbet, Cécile Goujard +8 more
Viral load 12 months after withdrawal of transient effective HAART started during primary infection is similar to viral load at the same time after infection in never-treated patients, suggesting that early HAART initiation does not lower the virological set-point.
AIDSVirological and immunological effects of short-course antiretroviral therapy in primary HIV infection
60 Citations2002Sarah Fidler, Annette Oxenius +8 more
SCART at PHI was safe, did not induce the development of drug resistance, and appeared sufficient to preserve HIV-specific CD4 T-helper responses, however, PHI is highly heterogeneous, and a large-scale randomized trial of SCart at PHI is now needed.
AIDST cell changes after combined nucleoside analogue therapy in HIV primary infection
49 Citations1999Guislaine Carcelain, Catherine Blanc +10 more
These results show that early therapy with nucleoside analogues can correct the immunological abnormalities observed in CD4 and CD8 T cell subsets at the time of PHI, and early kinetics in T cell recovery appears to be faster than in established disease.
The Journal of Infectious DiseasesVirological and Immunological Effects of Combination Antiretroviral Therapy with Zidovudine, Lamivudine, and Indinavir during Primary Human Immunodeficiency Virus Type 1 Infection
41 Citations2000Don Smith, M. Michelle Berrey +10 more
Combination therapy with zidovudine, lamivUDine, and indinavir during primary HIV infection results in a profound and sustained reduction in virus load with concurrent recovery of the CD4 cell population.
PubMedThe cumulative risk of AIDS as the CD4 lymphocyte count declines.
36 Citations1992A. N. Phillips, C. A. Lee +3 more
The Kaplan-Meier (product-limit) estimates, of the proportion of individuals developing AIDS before reaching a given low CD4 lymphocyte count, may be useful for determining when prophylactic treatment should begin.
AIDSSlower CD4 cell decline following cessation of a 3 month course of HAART in primary HIV infection: findings from an observational cohort
33 Citations2007Sarah Fidler, Julie Fox +5 more
A short course of ART at PHI may delay CD4 cell decline and requires a randomized clinical trial powered to address definitively the role of ART intervention in PHI.
Statistics in MedicineEstimating patterns of CD4 lymphocyte decline using data from a prevalent cohort of HIV infected individuals
22 Citations1994Eric Vittinghoff, Hina M. Malani +1 more
Two methods using locally-weighted linear smoothers are applied to data from a prevalent cohort of HIV-infected homosexual men, giving estimates of the average pattern of CD4 lymphocyte decline.
Clinics in DermatologyNatural history of HIV-1 infection
20 Citations2000Giota Touloumi, A Hatzakis
Initial results from clinical trials suggest that highly active antiretroviral therapy (HAART), which combines RTI and PI, results in viral-load reduction and possibly long-lasting immune recovery, and may radically change the natural history of HIV-1 infection.
HIV MedicineEstimating the effect of antiretroviral treatment during HIV seroconversion: impact of confounding in observational data
10 Citations2003CASCADE Collaboration
To assess whether treatment with antiretroviral drugs within the first 3 months of infection with HIV affects medium‐term health outcomes, a large number of patients with confirmed or suspected HIV are receiving treatment within this period.
