AEGiS-13IAC: Clinical and virological response in 133 patients (pts) recruited and treated with HAART during HIV-1 primary infection (PI): the PRIMO cohort.

13th International AIDS Conference

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

Clinical and virological response in 133 patients (pts) recruited and treated with HAART during HIV-1 primary infection (PI): the PRIMO cohort.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrB614)

Deveau C, Goujard C, Ngo N, Harzic M, Pellegrin I, Garrigue I, Tamalet C, Rouzioux C, Laskri D, Delfraissy J-F, Meyer L
C. Deveau, INSERM U292, Hopital de Bicotre, 82 rue du General Leclerc, 94276, Le Kremlin-Bicotre, Cedex, France, Tel.: +33 1 01 49 59 19 75, Fax: +33 1 01 45 21 20 75, E-mail: meyer@vjf.inserm.fr

BACKGROUND: The objectives of the PRIMO cohort are to describe viro-immunological response during PI as well as changes with HAART.

METHODS: Since 1996, the French PRIMO multicenter cohort has enrolled 156 pts diagnosed during PI. The date of infection was documented by an incomplete western-blot (82% of cases), a positive antigenemia with a poor ELISA (8%), or an interval >6 months between a negative and a positive test (10%). Pts are followed at D14, M1, M3, M6 and then every 6 months.

RESULTS: Median age at PI was 32 years, 23% were female; PI was symptomatic in 71% of pts. The frequency of major genotypic mutations of the RT gene (215, 184, 74) at enrolment was respectively 3.9%, 4.5% and 1.0%. The first patient harbouring a major mutation in the protease gene was diagnosed in september 1997. HAART was initiated at enrolment in 91% of pts and mostly (80%) included 2 RT and a protease inhibitor. At M6, 45% of treated pts had an HIV RNA >20 copies/ml, 73% at M18. Pts with RNA >20 copies/ml at M6 had significantly higher CD4+ and lower plasma viral load at entry than pts remaining >20 copies at M6. These differences were still observed when restricting the comparison to compliant pts. Proviral DNA was quantified in 19 pts in whom plasma HIV RNA was >200 at M12 under HAART and compared with 10 other pts treated during chronic infection. Median DNA was 2.82 log/106 cells during PI and median reduction was -0.78 log at M12. This decrease was greater than the one observed during chronic infection (-0.52 log). A lipodystrophic syndrome was diagnosed in 25% of the pts, 58% had only metabolic abnormalities; the earlier diagnosis was diagnosed at the 6th month of treatment.

CONCLUSION: Most pts diagnosed with a PI between 1996 and 1999 were rapidly prescribed HAART, with a good efficacy. The decrease in proviral DNA appears more marked during treatment of PI than during chronic infection. However, 25% of pts developed a lipodystrophic syndrome under HAART.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV-1, Viral Load, HIV Infections, Female, Human, virology
000709
WeOrB614