Short-cycle therapy in adolescents after continuous therapy with established viral suppression: the impact on viral load suppression.

TitleShort-cycle therapy in adolescents after continuous therapy with established viral suppression: the impact on viral load suppression.
Publication TypePublication
Year of Publication2009
AuthorsRudy BJ, Sleasman J, Kapogiannis B, Wilson CM, Bethel J, Serchuck L, Ahmad S, Cunningham CK
Corporate AuthorsAdolescent Trials Network for HIV/AIDS Interventions
JournalAIDS Res Hum Retroviruses
Volume25
Issue6
Pagination555-61
Date Published2009 Jun
ISSN1931-8405
KeywordsAdolescent, Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, HIV Infections, Humans, Patient Compliance, Treatment Outcome, Viral Load, Young Adult
Abstract

<p>This was a proof-of-principle study to evaluate the impact of short cycle therapy (SCT; 4 days on/3 days off) in adolescents and young adults with good viral suppression on a protease inhibitor-based antiretroviral regimen. Subjects were recruited by the Adolescent Trials Network for HIV/AIDS Interventions and the Pediatric AIDS Clinical Trials Group. Subjects were infected either through perinatal/early childhood transmission or later via risk behaviors. All subjects were required to have at least 6 months of documented viral suppression below 400 copies/ml plus a preentry value below 200 copies/ml and an entry CD4+ T cell count above 350 cells/mm3. Of the 32 subjects enrolled, 12 (37.5%) had confirmed viral load rebound >400 copies, with 18 subjects (56%) coming off for any reason. The majority of subjects resuppressed when placed back onto continuous therapy using the same agents. Although no difference was found in virologic rebound rates between the early and later transmission groups, those infected early in life had higher rates of coming off SCT for any reason. There was no impact of SCT on the CD4+ T cell counts in those who remained on study or those who came off SCT for any reason. Subjects demonstrated good adherence to the SCT regimen. This study suggests that further evaluation of SCT may be warranted in some groups of adolescents and young adults infected with HIV.</p>

DOI10.1089/aid.2008.0203
Alternate JournalAIDS Res. Hum. Retroviruses
PubMed ID19534628
PubMed Central IDPMC2853866
Grant ListU01 HD 040533 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
U01-A141089 / / PHS HHS / United States
5-M01-RR-020359-04 / RR / NCRR NIH HHS / United States
R01 AI047723 / AI / NIAID NIH HHS / United States
UL1-RR-024134 / RR / NCRR NIH HHS / United States