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Predictive value of HIV ‐1 replication capacity and phenotypic susceptibility scores in antiretroviral treatment‐experienced patients
Author(s) -
Bedimo R,
Kyriakides T,
Brown S,
Weidler J,
Lie Y,
Coakley E,
Holodniy M
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2011.00981.x
Subject(s) - medicine , viral load , antiretroviral therapy , multivariate analysis , viral replication , randomized controlled trial , human immunodeficiency virus (hiv) , gastroenterology , immunology , virus
Objectives The aim of the study was to determine the prognostic value of HIV replication capacity ( RC ) for subsequent antiretroviral ( ARV ) treatment response in ARV ‐experienced patients. Methods RC and phenotypic resistance testing were performed at baseline and week 12 on plasma samples from patients randomized to undergo a 12‐week ARV drug‐free period ( ARDFP ) or initiate immediate salvage therapy (no‐ ARDFP group) in the O ptions in M anagement with A ntiretrovirals ( OPTIMA ) trial. Dichotomous and incremental phenotypic susceptibility scores ( dPSSs and iPSSs , respectively) were calculated. The predictive value of RC and PSS for ARV therapy response and/or ARDFP was evaluated using multivariate regression analysis and Pearson correlations. Results In 146 no‐ ARDFP subjects, baseline RC (50.8%) did not change at week 12 and was not correlated with CD4 cell count or viral load changes at week 12 ( P = 0.33 and P = 0.79, respectively) or at week 24 ( P = 0.96 and P = 0.14, respectively). dPSS predicted virological but not CD4 cell count response to ARV therapy at weeks 12, 24 and 48 ( P = 0.002, P < 0.001 and P = 0.005, respectively). RC was significantly correlated with dPSS and iPSS at baseline, but did not increase their predictive value. In the 137 ARDFP patients, RC increased significantly (from 52.4 to 85.8%), but did not predict CD4 cell count and viral load changes during ARDFP ( P = 0.92 and P = 0.26, respectively). RC after ARDFP did not predict subsequent CD4 cell count and viral load changes 12 weeks following ARV treatment reinitiation ( P = 0.90 and P = 0.29, respectively). Conclusions We found no additional predictive value of replication capacity for virological or immunological responses (above what PSS provides) in patients undergoing salvage ARV treatment.