17th International HIV Drug Resistance Workshop 10-14 June 2008, Sitges, Spain

HIV DNA VIRAL LOAD EVOLUTION UNDER A RALTEGRAVIR-BASED THERAPY

Antivir Ther. 2008; 13(Suppl. 3):A21 (abstract no. 19)

C Charpentier^1,2, C Piketty³, D Laureillard³, P Tisserand¹, L Weiss^2,3, L Bélec^1,2 and A Si-Mohamed^1
1Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Paris, France; ²Faculté de Médecine René Descartes, Université Paris V, Paris, France; ³Service d’Immunologie Clinique, Hôpital Européen Georges Pompidou, Paris, France

BACKGROUND: The recent antiretroviral drug class of integrase inhibitors, including raltegravir (RAL), is also expected to have a possible effect on HIV DNA viral load level. However, few data are available about HIV DNA level evolution during a RAL-based regimen.

METHODS: Eighteen highly experienced patients initiated a RAL-containing salvage regimen. Plasma and peripheral blood mononuclear cells samples were collected for all patients at baseline and at week 12 (W12) of RAL; HIV RNA and HIV DNA viral loads were assessed. HIV DNA quantification assessed total HIV DNA, integrated and unintegrated, using the real-time PCR procedure previously described with the NEC005, NEC131 primers and the MLC1 probe.

RESULTS: Among the 18 patients, baseline median HIV RNA level and CD4+ T-cell count were 4.05 log₁₀ copies/ml (range 2.00–5.56) and 29 cells/mm³ (range 3–109), respectively. Median baseline HIV DNA viral load was 3.50 log₁₀ copies/10⁶ cells (range 2.12–4.78). At W12 of RAL-based regimen, eight of the patients exhibited an HIV viral load <40 copies/ml; among the 10 remaining patients median HIV viral load was 2.12 log₁₀ copies/ml (range 1.67–4.65). Median HIV DNA level at W12 was 2.95 log₁₀/10⁶ cells (range 2.39–4.42). Median HIV DNA viral load decrease between baseline and W12 was -0.48 log₁₀/10⁶ cells (range -2.26 – +0.39). The degree of HIV DNA decrease does not correlate with CD4+ T-cell count or HIV RNA level at baseline. However, the degree of HIV DNA decrease was found to be correlated with HIV DNA baseline level (R=0.28; P=0.03). The HIV DNA level/CD4+ T-cell count ratio decrease between baseline and W12 was correlated with the magnitude of the HIV RNA level reduction (R=0.35; P=0.01).

CONCLUSIONS: Our data showed no drastic effect of RAL on total HIV DNA level as only a median decrease of -0.48 log₁₀/10⁶ cells was observed at W12. However, when HIV DNA was reported to the proportion of CD4+ T-cell count, a correlation was found with the magnitude of HIV RNA decrease. Thus, these findings may suggest that newly CD4+ T-cells generated during treatment may integrate less of HIV DNA copies.

2008-06-10
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