Immunologic and virologic response to highly active antiretroviral therapy in the Multicenter AIDS Cohort Study

Traci E. Yamashita, John P. Phair, Alvaro Munoz, Joseph Bernard Margolick, Roger Detels, Stephen J. O'Brien, John W. Mellors, Steven M. Wolinsky, Lisa Paula Jacobson

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate prior antiretroviral therapy experience and host characteristics as determinants of immunologic and virologic response to highly active antiretroviral therapy (HAART). Methods: We studied 397 men from the Multicenter AIDS Cohort Study (MACS) who initiated HAART between October 1995 and March 1999. CD4 cell count and HIV-1 RNA responses to HAART were measured at the first visit following HAART (short-term) and extending from the first visit to approximately 33 months after HAART (long-term). Prior antiretroviral experience was classified into three groups based on antiretroviral therapy use during the 5 years prior to HAART. Age, race and host genetic characteristics also were assessed for their effects on treatment response. Results: Better short- and long-term CD4 cell and HIV-1 RNA responses were observed in the treatment-naive users. Intermittently and consistently experienced users did not significantly differ in response. Whereas race did not independently affect response, among those initiating HAART with > 400 × 106 CD4 cells/l, younger age and the Δ32 CCR5 genotype were associated with a better short-term CD4 cell response. There was a suggestion that having the protective CCR5 genotype also was associated with a better long-term CD4 cell response. Conclusion: Immunologic and virologic response to HAART was stronger in individuals who had no prior experience with the antiretroviral therapy agents subsequently included in their initial HAART regimen. Age, level of immune competence and immunogenetics appeared to play a role in the subsequent immune reconstitution following use of highly effective HIV therapy.

Original languageEnglish (US)
Pages (from-to)735-746
Number of pages12
JournalAIDS
Volume15
Issue number6
DOIs
StatePublished - Apr 13 2001

Fingerprint

Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
Cohort Studies
HIV-1
Therapeutics
Genotype
RNA
Anti-Retroviral Agents
Immunogenetics
CD4 Lymphocyte Count
Mental Competency
HIV

Keywords

  • Genetic markers
  • Highly active antiretroviral therapy
  • HIV-1
  • Immunologic response
  • Prior antiretroviral experience
  • Virologic response

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Immunologic and virologic response to highly active antiretroviral therapy in the Multicenter AIDS Cohort Study. / Yamashita, Traci E.; Phair, John P.; Munoz, Alvaro; Margolick, Joseph Bernard; Detels, Roger; O'Brien, Stephen J.; Mellors, John W.; Wolinsky, Steven M.; Jacobson, Lisa Paula.

In: AIDS, Vol. 15, No. 6, 13.04.2001, p. 735-746.

Research output: Contribution to journalArticle

Yamashita, Traci E. ; Phair, John P. ; Munoz, Alvaro ; Margolick, Joseph Bernard ; Detels, Roger ; O'Brien, Stephen J. ; Mellors, John W. ; Wolinsky, Steven M. ; Jacobson, Lisa Paula. / Immunologic and virologic response to highly active antiretroviral therapy in the Multicenter AIDS Cohort Study. In: AIDS. 2001 ; Vol. 15, No. 6. pp. 735-746.
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AU - Margolick, Joseph Bernard

AU - Detels, Roger

AU - O'Brien, Stephen J.

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AU - Wolinsky, Steven M.

AU - Jacobson, Lisa Paula

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