J. Frottier et al., PREDICTORS OF VIRAL LOAD RESPONSE IN TRIPLE THERAPY WITH PROTEASE INHIBITOR IN HIV-INFECTED PATIENTS, Bulletin de l'Academie nationale de medecine, 182(5), 1998, pp. 981-992
As many factors may be involved in therapeutic response to triple ther
apy with protease inhibitor (PI), the aim of this study was to determi
ne the influence of epidemiological factors (sex, risk factors), clini
cal status (previous number of AIDS defining events), immunological st
atus (baseline CD4 T cells count), virological factor (baseline viral
load), previous antiretroviral therapy and duration of AZT therapy (>
or < 6 monts), number of prescribed reverse transcriptase inhibitors (
RTI), therapeutic strategy (switch to different RTI or only addition o
f PI) and compliance, on early virological response (M2-M3) after init
iation of triple therapy with PI. These results concerned 167 patients
treated with triple therapy including PI. A viral load response was d
efined in three types : complete response (undetectable : < 500 copies
/ml) for 100 patients; partial response (significant decrease: > 0,5 l
og from baseline) for 30 patients and no response for 37 patients. Onl
y two parameters were associated of good virological response: no prev
ious antiretroviral therapy (p < 0,001) and good compliance (p < 0,001
). No significant difference was observed between patients with no pri
or therapy and pretreated patients, in terms of median baseline CD4 co
unt and observance. The baseline median viral load was higher in naive
patients despite a better response. In pretreated patients, the type
of response appeared to be dependent on the duration of AZT treatment
(p = 0,06) and good compliance (p = 0,06). Among the 100 patients with
initial complete response, only 23/81 were still undetectable after a
median of 13 months of therapy.