The Open Virology Journal

2008, 2 : 69-73
Published online 2008 October 16. DOI: 10.2174/1874357900802010069
Publisher ID: TOVJ-2-69

RESEARCH ARTICLE
Supersensitive Viral Load Assay in Predicting CD4-Guided Treatment Failure

Simone Langforda , Angele Gayet-Ageronb , Chris Duncombea , Thidarat Jupimaia , Apicha Mahanontharita , Sasisopin Kiertiburanakulc , Warangkana Munsakuld , Kiat Ruxrungthama,e , Bernard Hirschelb , Jintanat Ananworanich, *,a,f and Staccato Study Group
a The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand
b HIV Unit, Infectious Disease Department, Geneva University Hospital, Geneva, Switzerland
c Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
d Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand
e Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
f South East Asia Research Collaboration with Hawaii, Bangkok, Thailand

* Address correspondence to this author at the HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), 104 Rajdumri Road, Pathumwan, Bangkok 10330, Thailand; Tel: +66-2-255-7335, Ext. 129; Fax: +66-2-252-5779; E-mail: jintanat.a@hivnat.org

ABSTRACT

In HIV patients who discontinue highly active antiretroviral therapy (HAART), the degree of HIV RNA suppression at the time of treatment interruption may predict success of re-treatment after the interruption (STI). A case-control substudy of the Staccato trial in Thailand included CD4-guided STI subjects with HIV RNA > 50 copies /ml (virological failure cases, n=11) and HIV RNA < 50 copies/ml (controls, n=22) after 12-24 weeks of HAART re-treatment following a median of 2 STI cycles. Controls were matched for age, gender and pre-ART CD4 count. HIV RNA with 5 copies/ml detection limit was determined on pre-virological failure samples. HIV RNA increased in cases compared to controls with each successive STI cycle (p-trend across time-points 0.004). The last HIV RNA below 50 copies/ml was significantly higher among cases compared to controls (p=.004). Measuring HIV RNA below 50 copies/ml may be useful in predicting virological failure to STI.