Virological and Immunological Responses of Efavirenz- Based HAART Regimen Initiated in HIV-Infected Patients at CD4 < 100 Versus CD4 > 100 Cells/mm3 (cid:31)
Sasisopin Kiertiburanakul MD*, Somnuek Sungkanuparph MD*, Sasivimol Rattanasiri MSc**, Weerawat Manosuthi MD***, Asda Vibhagool MD*, Ammarin Thakkinstian PhD**
Affiliation : (cid:31) The abstract has been presented in the XV International AIDS Conference, Bangkok Thailand, 2004; TuPeB4517 * Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Clinical Epidemiology Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University *** Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi
Objective : To compare virological and immunological responsiveness of efavirenz (EFV)-based highly active
anti retroviral therapy (HAART) between patients with baseline CD4 < 100 and CD4 > 100 cells/mm3.
Materials and Methods : A prospective cohort study in antiretroviral-naive HIV-infected patients was con-
ducted between February and April 2002. Donated HAART regimen, consisting of stavudine, didanosine, and
EFV was initiated. The primary outcome was time to undetectable HIV RNA, < 50 copies/mL. Patients were
followed up every 12 weeks until 48 weeks (the end of the study).
Results : Forty-six patients were included, 21 patients for CD4 < 100 cells/mm3 and 25 patients for CD4 >100
cells/mm3. Median CD4 cell counts of these corresponding groups were 26.5 and 177 cells/mm3. Patients’
characteristics were similar between the two groups except CD4. The probability of undetectable HIV RNA at
12, 24, 36, and 48 weeks were 57.1% (95%CI, 37.7-78.1%), 76.2% (95%CI, 56.9-91.3%), 80.9% (95%CI,
62.3-94.0%), and 90.5% (95%CI, 68.9-99.1%) for the former group; and 64.0% (95%CI, 45.8-81.8%), 92.0%
(95%CI, 77.5-98.6%), 96.0% (95%CI, 83.0-99.7%), and 96.0% (95%CI, 83.0-99.7%) for the latter group.
Median time to undetectable HIV RNA was 12 weeks for both groups. Median CD4 change at 48 weeks was
171 and 132 cells/mm3, respectively (p = 0.232). The adverse events were similar between the two groups.
Conclusion : Initiation of EFV-based HAART regimen in HIV-infected patients at CD4 < 100 and > 100 cells/
mm3 gains similar immunological and virological response.
Keywords : AIDS, CD4, Efavirenz, Highly active antiretroviral therapy, HIV
