Term Plasma Human Immunodeficiency Virus RNA Suppression

To analyze factors associated with long-term (2 years) suppression of virus load (VL), we performed a nested case-control analysis of 1235 Human Immunodeficiency Virus Outpatient Study cohort participants who were well characterized by multiple VL and CD4+ cell count determinations. Of these patients, 286 (23.1%) had maintained undetectable VLs (i.e.,!400 copies/mm3 or!50 copies/mm3) for 2 years. Being treatment naive at the start of antiretroviral therapy was associated with a greater likelihood of achieving long-term suppression of VL (odds ratio [OR], 1.5; 95 % confidence interval, 1.0–2.0;). In multivariate models, abacavir,Pp.028 indinavir, efavirenz, and drug combinations that included both lamivudine and indinavir were the most effective treatments for achieving long-term suppression of VL (adjusted OR for each, 13.6; P value for each,!.01). Long-term suppression of VL is more likely in treatment-naive than in treatment-experienced patients, but there were several drugs—abacavir, efavirenz, indinavir, and drug combinations including lamivudine and indinavir—that appeared to be effective, whether they were part of a first or subsequent drug regimen. With regard to the extended survival for HIV-infected patients treated with HAART, the best predictors of increased length and better quality of life are debatable [1, 2]. However, a frequently used measure of success is the attainment of complete suppression of plasm