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First HAART in HIV-Infected Patients With High Viral Load: Value of HIV RNA Levels at 12 Weeks to Predict Virologic Outcome

Wake Forest University Health Sciences, Winston Salem, North Carolina

Jesús Troya, MD

Hospital Carlos , Madrid, Spain

Ivana Maida, MD

Istituto Malattie Infettive, Sassari, Italy

Leticia Pérez-Saleme, MD

Hospital de Especialidades CMN SXXI, IMSS, México DF, Mexico

Giovanni Satta, MD

Istituto Malattie Infettive, Sassari, Italy

Aimee Wilkin, MD, MPH

Wake Forest University Health Sciences, Winston Salem, North Carolina

Pablo Barreiro, MD, PhD

Hospital Carlos , Madrid, Spain

P. Samuel Pegram, MD

Wake Forest University Health Sciences, Winston Salem, North Carolina

Vincent Soriano, MD, PhD

Hospital Carlos , Madrid, Spain

Maria Stella Mura, MD, PhD

Istituto Malattie Infettive, Sassari, Italy

Marina Núñez, MD, PhD

Wake Forest University Health Sciences, Winston Salem, North Carolina, mnunez{at}wfubmc.edu

The aim of this study is to identify the role of incomplete suppression during the first months of highly active antiretroviral treatment (HAART) to predict virologic failure in patients with high levels of HIV replication. In a retrospective, longitudinal, and multicenter study, response to HAART was assessed in treatment-naive adults with HIV RNA >100 000 copies/mL, and factors predicting failure were analyzed through regression analyses. A total of 118 patients were included. Virologic failure occurred more often in patients with >500 copies/mL at week 12 (Cox regression: Exp (B) 3.22; P = .02). HIV RNA >500 copies/mL at week 12 predicted incomplete virologic response (odds ratio [OR] = 9.33; P = .002] but not viral rebound. Major antiretroviral resistant mutations were present in 11 of 14 patients. HIV RNA >500 copies/mL at week 12 of first HAART predicts incomplete virologic response in patients with high levels of replication at baseline. Most patients carried resistance mutations at the time of failure.

Key Words: HIV • HAART • high viral load • virologic failure • resistance mutations

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 5, 314-317 (2009)
DOI: 10.1177/1545109709343966


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