en
Scientific article
English

HIV RNA in plasma rebounds within days during structured treatment interruptions

Published inAIDS, vol. 17, no. 2, p. 195-199
Publication date2003
Abstract

OBJECTIVE: To evaluate time to viral rebound in patients undergoing repeated structured treatment interruptions (STI). METHOD: Fourteen chronically HIV-infected patients enrolled in the Swiss-Spanish Intermittent Treatment Trial (SSITT) underwent frequent blood sampling. Patients underwent four cycles of 2-week STI, followed by 8-week retreatment with the identical antiretroviral treatment (HAART) used before STI. At the fifth cycle, treatment was stopped for a longer period. Before each new STI, plasma viral load (VL) had to reach < 50 copies/ml. VL was measured during day 0 (last day on HAART) and on days 4, 8 and 14 during all five STI. RESULTS: During the first cycle, plasma HIV RNA increased to > 50 copies/ml (range, 67-88) in five patients at day 4, in eight patients (> 100 copies/ml) at day 8 and in 12 patients (> 100 copies/ml) at day 14. Cumulative analysis of the frequency of detectable HIV RNA at days 4, 8 and 14 compared with day 0 for all five cycles revealed nine patients with VL > 50 copies/ml [13 of 54 samples tested (24.1%); = 0.14] at day 4, 11 patients [33 of 58 samples tested (56.9%); < 0.0001] at day 8 and 12 patients [53 of 65 samples tested (81.5%); < 0.0001] at day 14. CONCLUSIONS: Significant viral replication can be induced during 1 week STI, and this may increase the risk of the emergence of drug resistance during long-term cycling. Therefore, short-term cycling strategies such as 1-week-on, 1-week-off treatment, although conceptually intriguing, should still be regarded as investigational and should be restricted to rigorously controlled clinical trials ideally involving patients who have never failed treatment before.

Keywords
  • Anti-HIV Agents/ administration & dosage
  • Antiretroviral Therapy, Highly Active/methods
  • Drug Administration Schedule
  • HIV/ physiology
  • HIV Infections/ drug therapy/virology
  • Humans
  • RNA, Viral/ blood
  • Viremia/virology
  • Virus Latency
  • Virus Replication/drug effects
Citation (ISO format)
FISCHER, Marek et al. HIV RNA in plasma rebounds within days during structured treatment interruptions. In: AIDS, 2003, vol. 17, n° 2, p. 195–199. doi: 10.1097/01.aids.0000042945.95433.4b
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ISSN of the journal0269-9370
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