Presentation on theme: "Transient HAART During PHI Prolongs the Total Time Off HAART in Patients Presenting with PHI: Data from the Dutch Primo-SHM Cohort R. Steingrover, S. Jurriaans,"— Presentation transcript:
Transient HAART During PHI Prolongs the Total Time Off HAART in Patients Presenting with PHI: Data from the Dutch Primo-SHM Cohort R. Steingrover, S. Jurriaans, J. Lange, J.M. Prins on behalf of the Primo-SHM study group
Introduction Is temporary HAART during PHI beneficial? To the individual: –lower plasma viral load set-point? –longer time off HAART?
Yes: –Girard, AIDS 2001 –Hecht, JID 2006 –Fidler, AIDS 2007 –Steingrover, CROI 2007 No: –Markowitz, JID 2002 –Fidler, AIDS 2002 –Desquilbet, AIDS 2004 –Streeck, JID 2006 Lower viral set-point in cohort studies?
Lower viral set-point: RCT Steingrover et al, Temporary ART During PHI Lowers the Viral Set-point: the Prospective Randomized Trial Primo-SHM CROI 2008, poster 698b
Introduction Is temporary HAART during PHI beneficial? To the individual: –lower plasma HIV viral load? –longer time off HAART?
Introduction Is temporary HAART during PHI beneficial? To the individual: –lower plasma HIV viral load? –longer time off HAART? Objective of current analysis
Methods Patients with PHI –Negative/indeterminate WB –Detectable plasma HIV-1 RNA –or –Negative screening < 180 days Participating in Prospective Primo-SHM Trial or Cohort
The time to (re)start HAART in the Cox' proportional hazards model adjusted for age and baseline CD4 count. p < 0.001
Conclusion Transient, early HAART during PHI prolongs the total time that patients can remain off HAART Other independent predictors: –Age –CD4 count at baseline Note: pVL at baseline is not an independent predictor
Discussion What is the effect of details of early treatment: –timing –duration Is treatment of PHI worth the effort? Confirmed by randomized trials? –Primo-SHM –SPARTAC
Acknowledgements AMC Dpt Internal Medicine - Jan Prins -Marlous Grijsen -Joep Lange -Nicollette Hulshof, Marian Nievaard, Bonnie Slegtenhorst Harold Doevelaar Dpt Experimental Immunology - Hanneke Schuitemaker Dpt Medical Microbiology -Suzanne Jurriaans, Nicole Back -Dpt Experimental Virology -Georgios Pollakis UMC Utrecht Dpt Immunology - Frank Miedema HIV monitoring foundation -Frank de Wolf - Rosalind Beard Participating sites Maastricht UMC EMC, Rotterdam HAGA, Den Haag KGH, Haarlem Leiden UMC MC Leeuwarden MST, Enschede OLVG, Amsterdam St. Elizabeth, Tilburg UMC Nijmegen All study participants