Virologic and Immunologic Consequences of Discontinuing Combination Antiretroviral-Drug Therapy in HIV-Infected Patients with Detectable Viremia

• Published in: The New England journal of medicine Vol. 344; no. 7; pp. 472 - 480
• Main Authors: Deeks, Steven G, Wrin, Terri, Liegler, Teri, Hoh, Rebecca, Hayden, Matthew, Barbour, Jason D, Hellmann, Nicholas S, Petropoulos, Christos J, McCune, Joseph M, Hellerstein, Marc K, Grant, Robert M
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 15.02.2001
• Subjects: Adult; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; antiretroviral agents; Antiretroviral drugs; Antiviral agents; Biological and medical sciences; CD4 antigen; CD4 Lymphocyte Count; Drug Resistance, Microbial; Drug therapy; Drug Therapy, Combination; HIV; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV Protease Inhibitors - pharmacology; HIV Protease Inhibitors - therapeutic use; HIV-1 - drug effects; HIV-1 - genetics; HIV-1 - isolation & purification; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Patients; Pharmacology. Drug treatments; Plasma; Proportional Hazards Models; Prospective Studies; Retrovirus; RNA, Viral - blood; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viremia - drug therapy; Human; Immunopathology; Interruption; Viremia; AIDS; Asymptomatic; Immune deficiency; Virology; Infection; Chemotherapy; Immunology; Treatment; Viral disease; Antiviral; Combined treatment; Biological effect; Detection
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM200102153440702

The goal of antiretroviral-drug therapy in patients with human immunodeficiency virus (HIV) infection is the complete suppression of viral replication. 1 , 2 Failure to achieve this goal is common in clinical practice, occurring at a rate of 40 to 70 percent. 3 – 5 Although failure to achieve complete viral suppression is common, failure in broader immunologic and clinical terms is uncommon, at least during the first 24 to 30 months of follow-up. 3 , 4 These observations suggest that the ability of the virus to deplete CD4 cells may be diminished despite ongoing viral replication. We studied the consequences of discontinuing therapy in patients . . .