Viral load trend in HIV-1 seropositive patients with different CD4 cell counts before starting HAART

Background: The efficacy of highly active antiretroviral therapy (HAART) wa s prospectively monitored in HIV-1 seropositive patients by analyzing HIV-1 RNA viral load. Objectives: The aim of the study was to evaluate the viral load course in two different groups of patients (group 1: CD4 > 400/mm(3), group 2: CD4 < 200/mm(3)) during a period ranging from 9 to 25 months. Stu dy design: HIV-1 viral load, at the start and during HAART, was analyzed in 117 patients who had previously been treated only with two anti-transcript ase drugs but were naive for protease inhibitors. Results: The results show ed that, after the beginning of therapy, high plasma HIV-1 RNA levels dropp ed to undetectable values ( < 50 copies HIV-RNA/ml) in one third of patient s over a mean period of about 9 months irrespective of the initial CD4 cell count, even though a viral reduction of at least 2 log, in a significantly shorter period of time (P < 0.001) was observed only among patients who be gan retroviral therapy with a higher CD4 cell count. Conclusion: The respon se to HAART was not dramatically affected by the initial CD4 count. Though restricted to a small number of subjects, the data support the idea that th erapeutic intervention can be effective even in an advanced stage of HIV-1 infection, when patients show a decreased number of CD4 T-lymphocytes. (C) 2000 Elsevier Science B.V. All rights reserved.