A study in the July 1 edition of the Journal of Acquired Immune Deficiency Syndromes shows that achieving sustained suppression of HIV viral load during the first 18 months of highly active antiretroviral therapy is a predictor of the long-term success of anti-HIV therapy, HIVandHepatitis.com reports.
The study, conducted by researchers at Johns Hopkins University, followed for four years 444 patients who started an anti-HIV drug regimen between March 1996 and December 1998. Of the study subjects, 36% achieved viral suppression to below 500 copies and maintained that level during the first 18 months of treatment, 26% initially lowered viral loads to below 500 but rebounded to a level of 1,000 copies or higher, and 38% did not achieve viral loads under 500 copies. The researchers determined that after five years of anti-HIV treatment, 89% of the group that maintained low viral loads, 76% of the rebound group, and 56% of the group that did not achieve low viral loads would be alive.
"Our findings highlight the prognostic implications of response to HAART in the first 18 months," the researchers concluded. "Patients achieving durable viral suppression had a very low risk of death, whereas five-year mortality was 44% in patients who did not achieve viral suppression."
The researchers did note, however, that the incidence of diabetes and increased blood lipid levels were higher in the group maintaining low viral loads. These conditions have been linked with the long-term use of anti-HIV medications.