HIV Viral Load Response to Antiretroviral Therapy According to the Baseline CD4 Cell Count and Viral Load
JAMAPublished 28 November 2001
Andrew Phillips
Citations292
SJR quartileQ1
SJR score5.35
SNIP10.71
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
Lower CD4 cell counts and higher viral loads at baseline were not associated with poorer virological outcome of ART, and those with baseline viral loads of greater than 100 000 copies/mL had a slower rate of achieving viral suppression.
Abstract
In this study, lower CD4 cell counts and higher viral loads at baseline were not associated with poorer virological outcome of ART. Those with baseline viral loads of greater than 100 000 copies/mL had a slower rate of achieving viral suppression.
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 MedicinePlasma Viral Load and CD4+ Lymphocytes as Prognostic Markers of HIV-1 Infection
2,085 Citations1997John W. Mellors, Alvaro Munoz +10 more
This study compared the prognostic value of plasma viral load with that of clinical, serologic, and cellular markers in a large cohort of HIV-infected men and incorporated the two most predictive markers-plasma viral load and CD4+ lymphocyte count-into a regression tree that is useful for assessing the prognosis of individual patients.
HIV MedicineBritish HIV Association guidelines for the treatment of HIV‐1‐infected adults with antiretroviral therapy 2008
1,093 Citations2008B G Gazzard, on behalf of the BHIVA Treatment Guidelines Writing Group
The 2008 BHIVA Guidelines have been updated to incorporate all the new relevant information since the last iteration and all the peer-reviewed publications and important, potentially treatment-changing abstracts from the last 2 years have been reviewed.
JAMAAntiretroviral Therapy in Adults
1,034 Citations2000Charles C. J. Carpenter, David A. Cooper +16 more
New England Journal of MedicineEfavirenz plus Zidovudine and Lamivudine, Efavirenz plus Indinavir, and Indinavir plus Zidovudine and Lamivudine in the Treatment of HIV-1 Infection in Adults
1,007 Citations1999Schlomo Staszewski, Javier O Morales-Ramirez +10 more
As antiretroviral therapy in HIV-1-infected adults, the combination of efavirenz, zidovudine, and lamivudine has greater antiviral activity and is better tolerated than the combination.
The LancetClinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study
933 Citations1999Bruno Ledergerber, Matthias Egger +10 more
The rate of virological failure of HAART was high among patients with a history of antiretroviral treatment, but the probability of clinical progression was low even in patients with viral rebound.
Annals of Internal MedicineHighly Active Antiretroviral Therapy in a Large Urban Clinic: Risk Factors for Virologic Failure and Adverse Drug Reactions
853 Citations1999Gregory M. Lucas, Richard E. Chaisson +1 more
The hypothesis was that the virologic response to HAART would be substantially worse among unselected patients in an inner-city clinic than among patients enrolled in clinical trials, and this study analyzed data from a cohort of protease inhibitor-naive patients in whom HAART was initiated in the clinic between March 1996 and February 1998.
AIDSInsights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients
554 Citations2000Antonella d’Arminio Monforte, Alessandro Cozzi‐Lepri +15 more
If the current HAART regimen caused no toxicity, less than 10% of naïve patients discontinue their firstHAART regimen because of failure after 1 year from starting therapy.
The LancetAIDS across Europe, 1994–98: the EuroSIDA study
459 Citations2000Amanda Mocroft, Christine Katlama +8 more
The findings lend support to the idea that treatment regimens can lower the incidence of ADIs, and the immediate risk of an ADI for a given CD4 lymphocyte count has declined over time and is lower among patients on HAART.
AIDSHIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy
424 Citations1999Steven G. Deeks, Frederick Hecht +5 more
Failure of potent protease inhibitor therapy to suppress HIV RNA levels below detectable levels is common in clinical practice, and can often be explained by their suboptimal use.
The Journal of Infectious DiseasesSustained CD4<sup>+</sup>T Cell Response after Virologic Failure of Protease Inhibitor–Based Regimens in Patients with Human Immunodeficiency Virus Infection
296 Citations2000Steven G. Deeks, Jason D. Barbour +3 more
For any given HIV RNA level measured 12 weeks after virologic failure, subsequent CD4+ T cell decline was slower in patients receiving a protease inhibitor-based regimen than in a historical control group of untreated patients, suggesting that transient or partial declines in plasma HIV RNA levels can have sustained effects on CD4- T cell levels.
AIDSSuppression of plasma viral load below 20 copies/ml is required to achieve a long-term response to therapy
259 Citations1998Janet Raboud, Joan Montaner +11 more
The results demonstrate that suppression of pVL below 20 copies/ml is necessary to achieve a long-term antiretroviral response and support the need for a revision of current therapeutic guidelines for the management of HIV infection.
Archives of Internal MedicinePredictors of Virological Success and Ensuing Failure in HIV-Positive Patients Starting Highly Active Antiretroviral Therapy in Europe
239 Citations2000R Paredes
HAART is associated with a favorable virological response if started when the baseline HIV-1 RNA level is low, if at least 2 new nucleoside retrotranscriptase inhibitors are added, and if standard doses of saquinavir hard gel capsule are avoided as a single protease inhibitor.
AIDSReasons for modification and discontinuation of antiretrovirals: results from a single treatment centre
229 Citations2001Amanda Mocroft, M Youle +10 more
There was a high rate of modification and discontinuation of highly active antiretroviral therapy regimens in the first 12 months, particularly due to toxicities, patient choice or poor compliance.
The Journal of Infectious DiseasesInfluence of Age on CD4 Cell Recovery in Human Immunodeficiency Virus–Infected Patients Receiving Highly Active Antiretroviral Therapy: Evidence from the EuroSIDA Study
218 Citations2001Jean‐Paul Viard, Amanda Mocroft +9 more
Time to a CD4 increase of >200x106 cells/L was shorter for patients in the younger age groups, as confirmed by multivariate analysis (P<10-4).
AIDSNatural history of serum HIV-1 RNA levels in 330 patients with a known date of infection
195 Citations2000Jean‐Baptiste Hubert, Marianne Burgard +10 more
The study extends to the early post-seroconversion phase the prognostic value of extracellular HIV-1 RNA levels and suggests that, in most HIV-infected individuals, a progressive loss of control of viral replication arises during the early years of HIV- 1 infection.
AIDSPredictors of optimal virological response to potent antiretroviral therapy
180 Citations1999William G. Powderly, Michael S. Saag +4 more
Baseline viral load, the change in viral load over the first 4 weeks of treatment, the 2 h post-dose nelfinavir levels and the time to respond to HIV RNA levels have the best predictive value in determining response and response duration.
AIDSFactors associated with clinical and virological failure in patients receiving a triple therapy including a protease inhibitor
177 Citations2000Sophie Grabar, Christian Pradier +9 more
In this study with large samples of patients, the use of saquinavir-hgc was associated with higher risk of virological failure at 12 months than were ritonavir and indinavir; no differences between protease inhibitors were found for clinical progression.
The American Journal of MedicineCorrelation between immunologic function and clinical subpopulations of patients with the acquired immune deficiency syndrome
171 Citations1985H. Clifford Lane, Henry Masur +7 more
Those patients who present with opportunistic infections as their initial clinical manifestation of AIDS may represent a subgroup with a more severe immunologic derangement prior to clinical diagnosis, and this finding is of importance in attempts to understand the pathogenesis of this syndrome.
AIDSPredictors of a viral response and subsequent virological treatment failure in patients with HIV starting a protease inhibitor
153 Citations1998Amanda Mocroft, M. John Gill +2 more
A significant proportion of patients in a routine clinic setting achieved an undetectable viral load measurement after first starting a protease inhibitor; viral load in patients with a higher CD4 cell count was more likely to become and stay undetECTable.
Sozial- und PräventivmedizinThe Swiss HIV Cohort Study: Rationale, organization and selected baseline characteristics
148 Citations1994the Swiss HIV Cohort Study (SHCS), Bruno Ledergerber +3 more
The SHCS serves multiple purposes as a research project, as infrastructure for multidisciplinary research and as a tool to improve patient care as well as several international and national trials, post-marketing surveillances and expanded access protocols were or still are based upon its infrastructure.
AIDSDeterminants of sustainable CD4 lymphocyte count increases in response to antiretroviral therapy
138 Citations1999Schlomo Staszewski, Veronica Miller +9 more
AIDSVirological response to protease inhibitor therapy in an HIV clinic cohort
120 Citations1999Schlomo Staszewski, Veronica Miller +7 more
Starting protease inhibitors therapy with two other new antiretroviral drugs simultaneously with protease inhibitor therapy offers a better best chance of achieving sustained viral load < 500 copies/ml than starting fewer new drugs.
Journal of Clinical MicrobiologyMulticenter comparison of three commercial methods for quantification of human immunodeficiency virus type 1 RNA in plasma
116 Citations1996Rob Schuurman, Diane Descamps +9 more
Three procedures for the quantification of human immunodeficiency virus type 1 (HIV-1) RNA from plasma were compared at three laboratories and all three assays demonstrated equal reliability, which was independent of batched or unbatched analysis of replicate samples.
AIDSWhen to start highly active antiretroviral therapy in chronically HIV-infected patients: evidence from the ICONA study
107 Citations2001Alessandro Cozzi Lepri, Andrew Phillips +13 more
There was no clear immunological or virological advantage in starting HAART at a CD4 cell count > 350 rather than at 200–350 × 106 cells/l, and the increase in CD4 cells restored by HAART is meaningful in that they are associated with reduced risk of disease/death.
AIDSImmunological, virological and clinical response to highly active antiretroviral therapy treatment regimens in a complete clinic population
87 Citations2000Amanda Mocroft, Helen Devereux +8 more
There was a high rate of virological relapse, which varied considerably according to the definition of failure used, and the rates of clinical progression and hospital admissions observed to date were low.
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.
JAIDS Journal of Acquired Immune Deficiency SyndromesCourse of Viral Load Throughout HIV-1 Infection
81 Citations2000Caroline Sabin, Helen Devereux +5 more
The risk of developing AIDS and death remained low when the HIV-1 RNA level was below 4 log10 copies/ml, but increased rapidly thereafter, supporting current guidelines for the initiation of antiretroviral therapy after the viral load has exceeded this level.
The Journal of Infectious DiseasesCD4 Lymphocyte Count as a Predictor of the Duration of Highly Active Antiretroviral Therapy–Induced Suppression of Human ImmunodeficiencyVirus Load
75 Citations1999Veronica Miller, Schlomo Staszewski +8 more
Lower baseline CD4 cell counts were associated with increased risk of viral rebound; however, this risk was significantly reduced in persons with low baseline CD 4 cell counts who experienced substantial increases in CD4 Cell counts during follow-up.
The Journal of Infectious DiseasesLongitudinal Human Immunodeficiency Virus Type 1 Load in the Italian Seroconversion Study: Correlates and Temporal Trends of Virus Load
74 Citations1999Cynthia M. Lyles, Maria Dorrucci +8 more
In long-term follow-up, virus load exhibited a gradual and sustained increase over time and virus load and annual increase are strong predictors of disease progression.
Journal of Acquired Immune Deficiency Syndromes & Human RetrovirologyLongitudinal HIV-1 RNA Levels in a Cohort of Homosexual Men
67 Citations1998Thomas R. OʼBrien, Philip S. Rosenberg +2 more
It is concluded that most HIV-1-infected persons lack a long-term viral setpoint and that failure to account for evolution of the viral level can lead to underestimation of the risk of progression.
Journal of Acquired Immune Deficiency Syndromes & Human RetrovirologyRegional Differences in Use of Antiretroviral Agents and Primary Prophylaxis in 3122 European HIV-Infected Patients
65 Citations1997Jens Lundgren, Andrew Phillips +11 more
ARV therapy was more frequently used among patients from southern and central Europe as compared with patients from northern Europe, especially among patients with CD4 counts >200 cells/microl, and antifungal therapies are used differently in different parts of Europe.
Journal of Clinical InvestigationPredicting the duration of antiviral treatment needed to suppress plasma HIV-1 RNA
52 Citations2000Gian Paolo Rizzardi, Rob J. de Boer +13 more
Baseline plasma viremia emerged as the factor most tightly correlated with the duration of treatment required, allowing us to estimate the required time as a function of this one measure.
AIDSEffects of age at seroconversion and baseline HIV RNA level on the loss of CD4+ cells among persons with hemophilia
43 Citations1998Giota Touloumi, Angelos Hatzakis +3 more
By 24 months after HIV seroconversion, the oldest subjects and those with the highest HIV RNA levels during early chronic infection had experienced the most severe depletion of CD4+ cells.
The LancetRisk of new AIDS diseases in people on triple therapy
40 Citations1999Veronica Miller, Schlomo Staszewski +4 more
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.
Antiviral TherapyAvanti 1: Randomized, Double-Blind Trial to Evaluate the Efficacy and Safety of Zidovudine plus Lamivudine versus Zidovudine plus Lamivudine plus Loviride in HIV-Infected Antiretroviral-Naive Patients
24 Citations1999Josep M. Gatell, J Lange +2 more
The main outcome measures were degree and duration of reduction of plasma HIV-1 RNA as measured by RNA PCR and the development of drug-related toxicities sufficiently severe to warrant dose modification, interruption or permanent discontinuation.