The dissociation between virological and immunological responses to HAART
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2005
Authors
Jevtović, Đorđe
Salemović, Dubravka
Ranin, Jovan
Pešić, I.
Zerjav, S
Đurković-Đaković, Olgica

Article (Published version)

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While HAART allows for the reconstitution- of immune functions in most treated HIV patients, discrepant responses including failure to achieve a significant increase in circulating CD4+ T cells despite undetectable plasma viral loads (pVL), or a good immunological response while not reaching undetectabie viremia, may occur. Thus, to evaluate the incidence of and risk factors for discrepant responses to HAART, we conducted a retrospective study of all 446 patients treated with HAART between 1 January 1998 and 31 August 2004 in our HIV unit. CD4+ T cell counts and pVL values at baseline and end of study were parameters of the type of response. Within a mean follow-up period of 33 months, discrepant immunological and virological responses occurred in even 50% patients. Of these, 174(39%) did not have a rise in CD4+ T cells to above 400 per mu l despite a good virological response (type 1 dissociation), while 49 (11.0%) had a rise in the CD4+ T cell count to at least 200 per mu l but their... pVL was not undetectable (type 2 dissociation). The risk factors for immunological failure despite an undetectable pVL were baseline CD4+ T cells below 100 per mu l (OR 1.44, 95%CI 1.02-2.03) and HAART composed of three NRTIs (OR 1.92,95% CI 1.35-2.73), while usage of two NRTIs in combination with PI(s) (OR 0.36,95% CI 0.2 6-0.49), as well as simultaneous usage of all three drug classes (OR 0.37, 95% CI 0.26-0.53) were shown to be protective. The usage of PI-containing HAART regimens was protective against type 2 dissociation (OR = 0.40, 95% CI 0.19-0.83). Importantly, there were no differences in the survival of HAART-treated patients irrespective of the type of response.
Keywords:
HIV / HAART / virological/immunological dissociationSource:
Biomedicine & Pharmacotherapy, 2005, 59, 8, 446-451Publisher:
- Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux
DOI: 10.1016/j.biopha.2005.07.006
ISSN: 0753-3322
PubMed: 16140494
WoS: 000232464500004
Scopus: 2-s2.0-25644432892
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Institut za medicinska istraživanjaTY - JOUR AU - Jevtović, Đorđe AU - Salemović, Dubravka AU - Ranin, Jovan AU - Pešić, I. AU - Zerjav, S AU - Đurković-Đaković, Olgica PY - 2005 UR - http://rimi.imi.bg.ac.rs/handle/123456789/114 AB - While HAART allows for the reconstitution- of immune functions in most treated HIV patients, discrepant responses including failure to achieve a significant increase in circulating CD4+ T cells despite undetectable plasma viral loads (pVL), or a good immunological response while not reaching undetectabie viremia, may occur. Thus, to evaluate the incidence of and risk factors for discrepant responses to HAART, we conducted a retrospective study of all 446 patients treated with HAART between 1 January 1998 and 31 August 2004 in our HIV unit. CD4+ T cell counts and pVL values at baseline and end of study were parameters of the type of response. Within a mean follow-up period of 33 months, discrepant immunological and virological responses occurred in even 50% patients. Of these, 174(39%) did not have a rise in CD4+ T cells to above 400 per mu l despite a good virological response (type 1 dissociation), while 49 (11.0%) had a rise in the CD4+ T cell count to at least 200 per mu l but their pVL was not undetectable (type 2 dissociation). The risk factors for immunological failure despite an undetectable pVL were baseline CD4+ T cells below 100 per mu l (OR 1.44, 95%CI 1.02-2.03) and HAART composed of three NRTIs (OR 1.92,95% CI 1.35-2.73), while usage of two NRTIs in combination with PI(s) (OR 0.36,95% CI 0.2 6-0.49), as well as simultaneous usage of all three drug classes (OR 0.37, 95% CI 0.26-0.53) were shown to be protective. The usage of PI-containing HAART regimens was protective against type 2 dissociation (OR = 0.40, 95% CI 0.19-0.83). Importantly, there were no differences in the survival of HAART-treated patients irrespective of the type of response. PB - Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux T2 - Biomedicine & Pharmacotherapy T1 - The dissociation between virological and immunological responses to HAART EP - 451 IS - 8 SP - 446 VL - 59 DO - 10.1016/j.biopha.2005.07.006 UR - conv_1695 ER -
@article{ author = "Jevtović, Đorđe and Salemović, Dubravka and Ranin, Jovan and Pešić, I. and Zerjav, S and Đurković-Đaković, Olgica", year = "2005", abstract = "While HAART allows for the reconstitution- of immune functions in most treated HIV patients, discrepant responses including failure to achieve a significant increase in circulating CD4+ T cells despite undetectable plasma viral loads (pVL), or a good immunological response while not reaching undetectabie viremia, may occur. Thus, to evaluate the incidence of and risk factors for discrepant responses to HAART, we conducted a retrospective study of all 446 patients treated with HAART between 1 January 1998 and 31 August 2004 in our HIV unit. CD4+ T cell counts and pVL values at baseline and end of study were parameters of the type of response. Within a mean follow-up period of 33 months, discrepant immunological and virological responses occurred in even 50% patients. Of these, 174(39%) did not have a rise in CD4+ T cells to above 400 per mu l despite a good virological response (type 1 dissociation), while 49 (11.0%) had a rise in the CD4+ T cell count to at least 200 per mu l but their pVL was not undetectable (type 2 dissociation). The risk factors for immunological failure despite an undetectable pVL were baseline CD4+ T cells below 100 per mu l (OR 1.44, 95%CI 1.02-2.03) and HAART composed of three NRTIs (OR 1.92,95% CI 1.35-2.73), while usage of two NRTIs in combination with PI(s) (OR 0.36,95% CI 0.2 6-0.49), as well as simultaneous usage of all three drug classes (OR 0.37, 95% CI 0.26-0.53) were shown to be protective. The usage of PI-containing HAART regimens was protective against type 2 dissociation (OR = 0.40, 95% CI 0.19-0.83). Importantly, there were no differences in the survival of HAART-treated patients irrespective of the type of response.", publisher = "Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux", journal = "Biomedicine & Pharmacotherapy", title = "The dissociation between virological and immunological responses to HAART", pages = "451-446", number = "8", volume = "59", doi = "10.1016/j.biopha.2005.07.006", url = "conv_1695" }
Jevtović, Đ., Salemović, D., Ranin, J., Pešić, I., Zerjav, S.,& Đurković-Đaković, O.. (2005). The dissociation between virological and immunological responses to HAART. in Biomedicine & Pharmacotherapy Elsevier France-Editions Scientifiques Medicales Elsevier, Issy-Les-Moulineaux., 59(8), 446-451. https://doi.org/10.1016/j.biopha.2005.07.006 conv_1695
Jevtović Đ, Salemović D, Ranin J, Pešić I, Zerjav S, Đurković-Đaković O. The dissociation between virological and immunological responses to HAART. in Biomedicine & Pharmacotherapy. 2005;59(8):446-451. doi:10.1016/j.biopha.2005.07.006 conv_1695 .
Jevtović, Đorđe, Salemović, Dubravka, Ranin, Jovan, Pešić, I., Zerjav, S, Đurković-Đaković, Olgica, "The dissociation between virological and immunological responses to HAART" in Biomedicine & Pharmacotherapy, 59, no. 8 (2005):446-451, https://doi.org/10.1016/j.biopha.2005.07.006 ., conv_1695 .