부산대학교 도서관

Objectives: To describe the viral response to HAART by 4 and 8 weeks in previously antiretroviral (ART)-naive patients. To assess whether the 4-week or the 8-week viral loads (VL) are useful predictors of viral suppression by 16 weeks. Methods: Large clinical database including 398 ART-naive patients whose plasma VL was monitored every 4weeks. Observed probabilities of achieving a VL below 500 copies/mL by week 16 (days 84-119) from starting HAART were calculated. Results: Of the patients, 40.6% (121 of 298) reached a VL below 500 copies/mL by week 4 and 71.6% (189 of 264) by week 8. The chance of complete viral suppression by 4-8 weeks was higher in patients with lower pre-HAART VL. Among those whose VL was above 10000 copies/mL at week 4, 50% (16 of 32) achieved a VL below 500 copies/mL by week 16 (this chance was 25% in patients who started HAART with a VL above 1 million). Among patients whose VL was above 10000 copies/mL at week 8, only 38.1% (8 of 21) achieved a VL below 500 copies]mL by week 16. Conclusions: The 4-week and 8-week VL should be monitored to detect early signs of low subsequent chance of viral suppression. For previously ART-naive patients whose VL after 8 weeks of HAART is still above 10000, there is an urgent need to assess adherence to therapy, drug levels and resistance, perhaps with a view to an early change in therapy. [ABSTRACT FROM AUTHOR]