No pol mutation is associated independently with the lack of immune recovery in patients infected with HIV and failing antiretroviral therapy

✍ Scribed by Nicola Gianotti; Laura Galli; Maurizio Zazzi; Valeria Ghisetti; Stefano Bonora; Valeria Micheli; Paola Meraviglia; Paola Corsi; Bianca Bruzzone; Stefano Menzo; Simona Di Giambenedetto; Andrea De Luca; Gaetano Filice; Giovanni Penco; Antonella Castagna; on behalf of the ARCA database initiative

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 233 KB
• Volume: 83
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.21989

✦ Synopsis

Abstract

An investigation was undertaken to determine whether specific pol mutations hinder long‐term immune recovery regardless of virological response. In total, 826 patients with >50 HIV RNA copies/ml, who underwent genotypic resistance testing between 1 January 2000 and 31 December 2003 after >3 years of antiretroviral treatment, and were followed up for >3 years after genotypic resistance testing, were analyzed retrospectively. The outcome of the study was the lack of immune recovery after >3 years of follow‐up, defined as a slope by linear regression <0. The viremia detectability ratio was defined as the number of HIV RNA values of >50 copies/ml divided by the number of HIV RNA measurements during follow‐up. Logistic regression was used for univariable and multivariable analysis. Median (Q1, Q3) values at baseline were the following: age 40 (37, 45) years, years on antiretroviral therapy 4.45 (3.65, 5.47), HIV RNA 3.91 (3.39, 4.53) log~10~ copies/ml, CD4+ T‐cell 358 (211, 524)/µl. After 3.13 years of follow‐up, 375 patients (45.4%) showed a lack of immune recovery. The risk of lack of immune recovery increased independently with increasing baseline CD4+ counts (OR = 1.104 per 50‐cell increase, 95% CI = 1.069–1.142, P < 0.0001), increasing viremia detectability ratio during follow‐up (OR = 1.145 per 0.1‐unit increase, 95% CI = 1.093–1.202, P < 0.0001), and with earlier calendar years of resistance testing (overall effect: P = 0.0007). In conclusion, no pol mutation is associated independently with the lack of immune recovery. J. Med. Virol. 83:391–398, 2011. © 2011 Wiley‐Liss, Inc.