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Virological and immunological effects of combination antiretroviral therapy with zidovudine, lamivudine, and indinavir during primary human immunodeficiency virus type 1 infection

par Smith, Don D.E.;Weber, Rainer;Corey, Lawrence;Cooper, David;Berrey, Michelle Michelle;Robertson, Michael;Mehrotra, Devan;Markowitz, Martin;Perrin, Luc;Clumeck, Nathan ;Lazzarin, Adriano;Burckhardt, Beat
Référence The Journal of infectious diseases, 182, 3, page (950-954)
Publication Publié, 2000

Article révisé par les pairs

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Résumé :

Forty-seven patients presenting with primary human immunodeficiency virus (HIV) infection were treated with zidovudine 200 mg 3 times a day, lamivudine 150 mg 2 times a day, and indinavir 800 mg 3 times a day for 1 year. From a mean pretreatment viral RNA level of 4.93 log10 copies/mL, the proportions of patients having <500 copies/mL at 24 and 52 weeks were 92.0% and 89.2%, respectively. For the 35 patients with data available at 24 and 52 weeks, the corresponding proportions for the <50 copies/mL analysis were 86.6% and 79.3%, respectively. The change in virus load was -2.19 and -2.41 log10 copies/mL at weeks 8 and 52, respectively. CD4 cell counts increased, from a mean of 546 cells/mm3, by 142 cells/mm3 at week 24 and by 210 cells/mm3 at week 52. Three patients discontinued the study because of drug-related toxicity. Six (12.8%) patients had adverse experiences associated with nephrolithiasis. Combination therapy with zidovudine, lamivudine, and indinavir during primary HIV infection results in a profound and sustained reduction in virus load with concurrent recovery of the CD4 cell population.