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Improved virological and immunological efficacy of resistance-guided switch in antiretroviral therapy: a Frankfurt HIV cohort analysis

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Abstract

To evaluate the treatment outcome of antiretroviral therapy, depending on the use and utility of a concept of resistance-guided switch, patients from the Frankfurt HIV cohort have been followed for 24 weeks. If available, prior resistance data have been evaluated and patients were grouped into their expected viral response. The data of 354 patients were thus analysed, taking into account the genotypic sensitivity score of the administered medication (> or ≤2). When looking at the proportion of patients who achieved a viral load of <50/ml, the response rates differed significantly better for patients with a favourable resistance scoring as compared to an unfavourable one (71.9 % as compared to 56.0 %, p = 0.008). Interestingly, patients with a favourable resistance score also showed a better immunological response, as measured by median CD4 cell count of 391/µl [interquartal range (IQR) 250–530/µl] against 287/µl (IQR 174–449/µl) and a larger total increase of 141/µl against 38/µl. A significant virological and immunological benefit could be demonstrated for patients of a cohort with resistance-guided antiretroviral therapy adjustments.

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Abbreviations

HIV:

Human immunodeficiency virus

IQR:

Interquartal range

cART:

Combination antiretroviral therapy

NRTI:

Nucleoside reverse transcriptase inhibitor

NNRTI:

Non-nucleoside reverse transcriptase inhibitor

PI:

Protease inhibitor

CD (e.g. in CD4):

Cluster of differentiation (for cell epitopes)

RNA:

Ribonucleic acid

DNA:

Desribonucleic acid

PCR:

Polymerase chain reaction

ml:

Milliliter

µl:

Microliter

GSS:

Genotypic sensitivity score

ePR:

Expected impaired/partial response

eCR:

Expected complete response

CDC:

Centers for Diseases Control and Prevention (Atlanta, GA, USA)

MSM:

Men having sex with men

i.v.:

Intravenous (drug user)

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Conflict of interest

All authors have declared no further conflict of interest, related to this article.

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Authors and Affiliations

  1. Infectious Diseases Unit at Medical Department No. 2, HIVCENTER, Hospital of the Johann Wolfgang Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt, Germany

    T. Wolf, B. Fuß, P. Khaykin, H. R. Brodt, S. Goepel, M. Bickel & C. Stephan

  2. Institute for Medical Virology, Hospital of the Johann Wolfgang Goethe-University, Paul Ehrlich Straße 40, 60596, Frankfurt, Germany

    A. Berger & M. Stuermer

  3. Infektiologikum Frankfurt, Stresemannallee 3, 60596, Frankfurt, Germany

    G. Knecht, P. Gute & M. Bickel

Authors
  1. T. Wolf
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  2. B. Fuß
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  3. P. Khaykin
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  4. A. Berger
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  5. G. Knecht
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  6. P. Gute
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  7. H. R. Brodt
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  8. S. Goepel
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  9. M. Bickel
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  10. M. Stuermer
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  11. C. Stephan
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Corresponding author

Correspondence to C. Stephan.

Additional information

M. Stürmer and C. Stephan have contributed equally to this work.

For Frankfurt HIV Cohort Study.

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Wolf, T., Fuß, B., Khaykin, P. et al. Improved virological and immunological efficacy of resistance-guided switch in antiretroviral therapy: a Frankfurt HIV cohort analysis. Med Microbiol Immunol 203, 409–414 (2014). https://doi.org/10.1007/s00430-014-0350-5

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  • DOI: https://doi.org/10.1007/s00430-014-0350-5

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