Baseline clinical parameters profiling HIV patients responsive to dual nucleoside analogue therapy: A retrospective case control study

Matthew Grow, S. C. Zell, P. H. Goodman

Research output: Contribution to journalArticle

Abstract

This is a retrospective review of persons prescribed dual nucleoside analogue treatment (tx) against HIV, and explores baseline clinical parameters that might predict successful response. A chart review was conducted of active HIV patients (pts) who are currently being treated under the auspices of university faculty in the surrounding geographic area. Of the 167 charts reviewed 34 pts met criteria for data collection. These were pts who were placed on dual nucleoside analogues, had a baseline viral load (VL) measurement, and a post-tx VL 4-8 weeks after initiation of therapy. Subjects were divided into responder (decrease in baseline viral load by .5 log) and non-responder groups (those whose viral load did not decrease by .5 log). Information was gathered concerning immune status (absolute CD4 count), initial and post tx VL, prior anti-retrovira] (ARV) tx, history of opportunistic infections (OI's), and baseline labs including a CBC and chemistry panel. A profile of responders (n=26) reveals that 42.3% were naïve to ARV therapy, 7.7% reported a Hx of OI's, and a moderate mean pre-treatment VL of 107432 copies/ml. Pts in this group exhibited a mean duration of response to therapy of 15.2 months. Of the non-responders (n=8) 50% were naïve to ARV therapy, 25% reported a Hx of OI's, and a mean pre-treatment VL of 231203 copies/ml. When the mean values of baseline labs were compared using univariate analysis with Student's t-test the following were found to be statistically significant. Responder Non-responders CD4 310.2 cells/mm3 156.5 cells/mm3 p=.035 HBG 14.6 g/dl 13.4 g/dl p=.028 ALB 4.3 g/dl 4.0 g/dl p=.039 Certain baseline clinical parameters are associated with increase response to dual nucleoside therapy and may help profile HIV pts apt to respond to such agents. A higher CD4 count in association with normal albumin and hemoglobin levels indicates better immune status and overall health. Under such circumstances pts may benefit solely from dual nucleosides for a significant duration of time.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Volume47
Issue number2
StatePublished - Feb 1999
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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