OBJECTIVE: To demonstrate durable suppression of plasma viremia in a patient despite antiviral discontinuation.
DESIGN: Retrospective chart review of patient follow prospectively by the authors.
METHOD: 58 year old male HIV positive for 8 years was begun on AZT and delavirdine as part of Upjohn protocol 021. Medications were taken from July 1994 until July 1996 when DDI was added.
RESULTS: In November 1996, all medications were discontinued due to cardiomyopathy. THe patient has remained free of plasma viremia (25 Roche Ultrasensitive Assay) for 14 months despite multiple acute internal medicine problems (heart failure, hyperparathyroidism). CD4 counts have remained stabe in the 400-500 range.
CONCLUSION: Though uncommon, it is possible that antiviral therapy can lead to prolonged suppression of plasma viremia despite medication discontinuation. Evaluation of clinical as well as viral specific and immunologic correlates is warranted.