HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy

Abstract

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. CD4 T cell counts remain above baseline for at least one year in most patients experiencing virological failure. Successful salvage therapy, which was uncommon, was associated with a low plasma HIV RNA at the time of the switch and the use of a new class of antiretroviral agents (NNRTI) in the salvage regimen.

HIV-1 Genotypic Resistance Patterns Predict Response to saquinavir–ritonavir Therapy in Patients in Whom Previous Protease Inhibitor Therapy Had Failed

“…For many persons, however, this therapy does not provide sustained viral suppression or durable clinical benefit (10,11). Potential reasons for the loss of viral suppression include host immune defects, poor adherence to therapy, pharmacologic factors, and drug resistance (10 -17).…”

Benchmarks for antiretroviral therapy

“…Baseline levels of viremia and numbers of CD4 + T cells are both important prognosticators (17)(18)(19)(20); higher levels of viremia and lower numbers of CD4 + T cells predict a shorter duration of viral suppression. The rate of decay of viremia and the depth of the nadir achieved are also prognostically important with regard to viral suppression (20)(21)(22)(23)(24).…”

CD4 count and viral load time‐courses in patients treated with highly active antiretroviral therapy and association with the CDC staging system

“…All forms were sent to a single institution for data to be transferred to a computer database. Patients were evaluated at baseline and at the 3rd, 6th and 12th months after starting NFV therapy [mean deviations 1 10.5 (95% confidence interval (CI) 9-12), [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and [1][2][3][4][5][6], respectively]. A large amount of sociodemographic, clinical and laboratory data, including CD4 cell count and viral load, was recorded for each patient.…”