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  • Oral presentation
  • Open Access

Short-term evaluation of immediately-treated patients with acute HIV infection, recently diagnosed in the National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania

  • 1, 2Email author,
  • 1, 2,
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  • 2, 3,
  • 2,
  • 2,
  • 2,
  • 1, 2,
  • 2, 3,
  • 2, 3,
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  • 1, 2 and
  • 1, 2
BMC Infectious Diseases201414 (Suppl 7) :O1

https://doi.org/10.1186/1471-2334-14-S7-O1

  • Published:

Keywords

  • Viral Load
  • Detectable Viral Load
  • Functional Cure
  • Median Viral Load
  • Infectious Disease Hospital

Background

The rapidly put-on-treatment in acute HIV infection (AHI) seems to achieve functional cure in up to 15% cases. This represents a huge difference, spontaneous elite-controllers being less than 0.5%.

Objective: To identify the AHI patients and to observe the immune-virological course under immediately-started antiretroviral treatment (ART).

Methods

All newly-diagnosed HIV-infected adults (>18 yo) in the last 18 months (01.2013-06.2014) in an infectious diseases hospital were considered. The including criteria for AHI group were: detectable HIV-RNA or positive antigen/antibody combination assays in the setting of a negative/indeterminate HIV Western blot. AHI group was classified accordingly to Fiebig stages and was further evaluated regarding CD4 count and viral load (VL) at diagnosis, at 3 and 6 months. ART initiation and the regimen were also registered.

Results

804 adults were newly-diagnosed HIV-positive, out of which 26 patients (2.32%) with AHI. The number of patients in Fiebig II/III, IV, V and VI stages was 8, 15, 2 and 1 respectively. The AHI-group had a median age of 31, IQR [25-34] and 3.1:1 male:female ratio. The median CD4 count was 435, IQR [251-775] and the median VL was 5.6 log10, IQR [4.7-7]. Eight out of 26 AHI patients immediately started ART, in Fiebig II/III and IV stages for 7 of them. The 8th received ARV treatment in eclipse phase (for 28 days, as post-exposure prophylaxis) then restarted ART in Fiebig VI stage, at diagnosis moment. The immediately-treated group had a median age of 24, IQR [20-29], a male:female ratio of 7:1 and all were symptomatic. The median CD4 count at diagnosis was 261, IQR [147-467] and the median VL was 7 log10, IQR [5.6-7], except the partially-treated in eclipse-phase patient, whose CD4 count was 789 and VL was 21977c/mL at diagnosis. In the immediately-treated group there was a rise in median CD4 count to 646, IQR [544-764] at month 3 and to 755, IQR [577-950] at month 6. The median VL declines to 1.6 log10, IQR [1.3-2.2] at month 6. Five patients received a 3-drugs regimen and 3 received a 4-drugs regimen. The immune-virological course couldn’t be correlated with a particular regimen or with the number of drugs used.

Conclusion

Two percent of newly diagnosed HIV-infected patient in 18 months in our setting had AHI and one third of them received immediate treatment. The short-term benefit was the consistent immune-virological improvement, regardless of ART scheme. However, more than half had detectable VL at month 6, probable due to the very high initial VL.

Authors’ Affiliations

(1)
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
(2)
National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania
(3)
Central Universitary Emergency Military Hospital Dr Carol Davila, Bucharest, Romania

Copyright

© Moroti et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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