Early viral suppression predicting long-term treatment success among HIV patients commencing NNRTI-based antiretroviral therapy

Abstract

Non-nucleoside reverse transcriptase inhibitor (NNRTI) -based antiretroviral therapy (ART) regimens have been recommended and widely used in resource-limited settings because of their reliable efficacy, low pill burden, and low cost. This study sought to determine outcomes and toxicities of NNRTI-based ART over a period of 208 weeks. A total of 244 HIV/AIDS Thai patients with a mean (±SD) age of 36 (±8.1) years initiated NNRTI-based ART in 2004. The median (inter-quartile range) baseline CD4 cell counts and HIV RNA levels were 34 (13-101) cells/mm3 and 5.4 (4.96-5.79) log copies/ml, respectively. At week 208, 84.6% of patients achieved HIV RNA loads <50 copies/ml, 88.5% continued NNRTI based regimens, 6.1% developed virologic resistance to NNRTIs, and 3.3% lost to follow up. Baseline CD4<50 cell/mm3 (p=0.019), and viral load ≥50 copies/ml at 6 months post-ARV (p<0.001) were associated with treatment failure. At the end of the study, 39.8% lipoatrophy and 35.7% hyperlipidemia were identified. In conclusion, NNRTI-based regimens result in high virologic success; early undetectable viral load is key to predicting long-term virologic success. © 2010 Soe AN, et al.