European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
81
D.6 (Vortrag)
Recovery of CD4+ T-cells after switch to a
nucleoside free regimen in patients with poor
immunologic response despite complete HIV-RNA
suppression
Lehmann C. 1 , Hofmann A. 1 , Cornely O. 1 , Jung N. 1 ,
Hartmann P. 1 , Norbert S. 1 , Wyen C. 1 , Fätkenheuer G. 1
1 Medizinische Klinik I, Klinische Infektiologie, Universität zu
Köln, Köln, Germany
Background: Antiretroviral Therapy (ART) usually leads to
suppression of HIV load and rapid rise of CD4+ T- cell count.
However, in some patients poor recovery of CD4+ T- cell despite
optimal viral suppression on ART is observed. As some
combinations of nucleoside analogues (NA) have been associated
with paradoxical depletion of CD4+ T- cells, we postulated
that the change from a NA containing to a NA free regimen
could improve quantitative immunological parameters.
Methods: 15 HIV-1 infected patients on NA containing ART
with undetectable HIV load and CD4+ T-cells < 250/L for at
least 6 months were included in this study after informed consent.
Treatment was switched to Atazanavir (ATV) (300mg
qd), Saquinavir (SQV, 1000mg bid) and Ritonavir (RTV,
100mg qd)
Results: Median [IQR], age [yrs.]: 46 [38-62]; gender: male:
n=11, CDC stage C3: n= 9, CD4+ T-cells/L at baseline: 197
[130-220], 10% [7-17]; months on ART: 20, [6-114]. The regimen
was well tolerated. 1 patient discontinued because of incompliance.
HIV RNA remained below 50 copies in 14 patients
and CD4+ T-cell count improved significantly, (week
24: 230L (14%), [170-290, 10-17%], week 48: 260/l, 17%
[195-415, 13.5-18.5%] p< 0.05)
Conclusions: This clinical pilot study shows that the boosted
double PI combination of ATV/SQV without the addition of
NA may be an effective and generally well-tolerated NAsparing
treatment strategy for patients with poor immunologic
response despite undetectable viraemia.
D.7 (Vortrag)
Long-term response on CD4 T-cell count recovery
in HIV-infected patients receiving highly active
antiretroviral therapy (HAART)
Kramer K. 1 , Vogel M. 1 , Voigt E. 1 , Wasmuth J. 1 ,
Schwarze-Zander C. 1 , Rockstroh J. 1
1 Department of Medicine I, University of Bonn, Bonn,
Germany
Objective: Several valid options for HAART initiation exist
for the treatment naïve, HIV-infected individual. Currently
however, there is an ongoing controversy over the potency of
NNRTI vs. PI based regimens on immune reconstitution. We
examined the potential superiority of one of these therapy arms.
Methods: Single cohort study. Retrospective chart review.
CD4 T-cell count was analyzed every 3 months in participants
who had been HAART-naïve at the time point of HAART initiation
and had a plasma HIV RNA load