AEGiS-13IAC: Psychological impact of intermittent treatment interruptions in patients with Non-Detectable HIV-1 Viral Load.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Psychological impact of intermittent treatment interruptions in patients with Non-Detectable HIV-1 Viral Load.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB748)

Tuldra A, Fumaz CR, Ferrer MJ, Romeu J, Ruiz L, Clotet B
A. Tuldra, Ctra de Canyet s/n, 08916 Badalona, Spain, Tel.: +34 93 465 12 00 (ext. 3549), Fax: +34 93 465 76 02, E-mail: atuldra@ns.hugtip.scs.es

BACKGROUND: HAART is useful but has also important constrains. Intermittent treatment interruption studies (ITI) may help to cope with such problems but they might represent an important cause of psychological disturbances.

METHODS: 12 HIV+ patients (pts) receiving antiretrovirals for >2 years were included. All had a CD4/CD8 ratio>1 and HIV-RNA>20 copies for > 24 months. The interruption of the therapy periods (ITP) were planned during 30 days or when viral load (VL)> 3000 copies/mL. After a ITP, pts returned to HAART for 12 weeks (wk), time when the next ITP started. Interviews for the assessment of psychological variables were performed at each ITP at wk 0 and 2, and 1 wk after the HAART's reintroduction (HR). Variables evaluated were: effort to take TT, self-perceived health status (HS), adverse events (AE) grade, impact of AE in daily life, quality of life (QOL), adherence (ADH), positive and negative aspects of ITP, emotional status and confidence in: a) TT, b) non VL rebound in current ITP, c) non VL rebound in any future ITPs, d) a new control of VL in case of rebound.

RESULTS: During the 1st ITP, QOL (p>0.001) and HS (p = 0.028) increased, decreasing 1 wk after HR (p = 0.002; p = 0.014). 2 pts presented new AE after the HR. At wk 0, 1 pt had ADH >100% but 3 pts had >100% ADH 1 wk after HR. The main positive aspects of ITP were schedule freedom and AE's resolution. The negative was the number of laboratory controls. During the 2nd ITP no differences were found in any variable. 1 wk after the 2nd HR, 8 pts referred AE and 3 pts had ADH>100%. 8 presented irregularities in drug schedule. The main positive aspect of the ITP was schedule freedom whereas the main negative aspect was the feeling of having to incorporate once again the habit of medication intake.

CONCLUSIONS: The initial ITI psychological benefits seem not to be stable. This observation and problems in ADH at the resumption of HAART might indicate the necessity of a closely support to pts in ITI.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Viral Load, HIV Infections, Drug Therapy, Combination, Antigens, CD4, Antigens, CD8, Human, therapy, Psychology, immunology, drug therapy
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ThOrB748