M. Youle et al., Changes in CD4 lymphocyte counts after interruption of therapy in patientswith viral failure on protease inhibitor-containing regimens, AIDS, 14(12), 2000, pp. 1717-1720
Objective: To describe the short-term changes in CD4 lymphocyte counts afte
r the interruption of antiretroviral HIV therapy in order to increase the u
nderstanding of CD4 lymphocyte dynamics, and so that appropriate monitoring
strategies can be designed.
Methods: We studied 35 HIV-infected patients with late-stage disease who ha
d therapy interruptions leading to high viral load levels, median greater t
han 750 000 RNA log(10) copies/ml, and in whom two CD4 cell counts (median
28 days apart) were available before beginning a salvage regimen.
Results: Overall, there was a substantial decline in CD4 cell counts from a
median of 125 to 83 cells/mm(3) in the average 28 day period, with median
proportionate and absolute losses of 26% and 24 cells/mm(3) per month, resp
ectively (P < 0.008). This tended to be greater in individuals studied soon
er after interrupting therapy (P = 0.03) and in those with CD4 cell counts
above the pre-therapy baseline (P = 0.06). There was a strong negative corr
elation between the proportionate increase in viral load and the absolute c
hange in CD4 cell count (-0.66, P = 0.0002).
Conclusion: Patients with relatively advanced HIV infection interrupting an
tiretroviral therapy after failing a protease inhibitor-containing regimen
require frequent monitoring because CD4 cell counts appear to fall quite ra
pidly, at least in the first few weeks after interruption (C) 2000 Lippinco
tt Williams & Wilkins.