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7th Annual Conference Of The British HIV Association [BHIVA]27 – 29 April 2001, The Hove Centre, Brighton |
[AUTHOR(S):] S Fidler, M Brady, A Oxenius, D Price, R Phillips, JN Weber
Jefferiss Trust Laboratories, Wright-Fleming Institute, Imperial College School of Medicine, St Mary's Hospital, London, UK
BHIVA Conf 2001 Apr 27-29;7:O4
STUDY DESIGN: PHI is defined by: positive polymerase chain reaction (PCR), p24 antigen, HIV-specific immunoglobulin M, positive Western blot Abbott De-tuned assay evolving seropositivity and symptoms of acute seroconversion illness. Patients are offered a choice of shortcourse highly active antiretroviral therapy (HAART), consisting of Combivir/nevirapine, or no therapy and are followed up monthly. Clinical endpoints: HIV-specific immune functional studies of both CD4 and CD8 responses measured with an enzyme-linked immunosorbent assay (ELISA), proliferation assays and tetramer staining technology. Secondary endpoints are viral load and time to fall in CD4 count to <350 cells/µl.
RESULTS: Of 23 PHI subjects identified, 20 were recruited to the study. Mean age was 26.3 years, and average time from infection to recruitment was 12 weeks with a range of 3–24 weeks. At recruitment, the mean baseline CD4 count was 448 cells/µl (range 90–710) and the mean baseline viral load was 166,966 HIV-1 RNA copies/ml (range 179 to >500,000). Eighteen patients chose to start therapy, and there were two untreated ‘controls’. Complete virological control was achieved in all subjects irrespective of pretherapy levels, indicating that this is a potent combination. Follow-up to 56 weeks post recruitment and 32 weeks off therapy shows good viral control with levels remaining <5000 copies/ml off therapy, and the preservation of broad HIVspecific CD4 and CD8 T-cell responses in contrast to untreated control PHIs, in whom initial vigorous early responses are subsequently lost.
CONCLUSIONS: Short-course HAART at PHI preserves HIV-specific CD4 T-cell responses and is associated with good long-term virological control.
PRESENTING AUTHOR:
010427
O4
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