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1st round: LA3 + LA7 2nd round: Jct f + LA1.
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1st round: LA3 + LA7 2nd round: Jct f + LA1 Assessment of residual HIV-1 viremia and persistent viral replication in highly suppressed patients: comparison of direct and indirect methods.B. Hernández-Novoa, N. Madrid, A. Vallejo, C. Gutiérrez, L. Díaz, M. Abad, E. Domínguez, V. Dahl, R. Rubio, E. Navas, J. Zamora, H. Valdez, S. Palmer, M.A. Muñoz-Fernández, S. Moreno. • Direct (Single copy assay-SCA) and indirect (2-LTR episomal DNA detection and immune activation) methods have been used to measure residual replication during suppressive HAART. • Results have been contradictory and comparisons of these methods are needed. • Clinical trial (NCT00795444) of maraviroc (MVC) intensification • SCA with an optimal threshold of 0.3 copies/ml • Qualitative 2-LTR PCR: • Flow cytometry of double positive CD4 and CD8 T cells • (CD38+HLA-DR+).
Significant changes were observed at week 12 (p=0.02) for SCA and at both timepoints (weeks 12 and 24) for 2-LTR-DNA detection (p=0.037 and p=0.012, respectively). • Agreement between both techniques was poor (Kappa=0.115). • A decrease in the median proportion of CD3+CD4+CD38+HLA-DR+ was observed at week 24 which was not statistically significant (1.6%, IQR:1.1-2.3; 2.9%, IQR:2.5-3.3 at BL). • This was also de case for activated CD8 T cells. • No correlation with the two other techniques was observed. • Conclusions • There was no correlation in the results obtained by the three methods used to measure residual viremia and persistent viral replication. • The reduction in CD4 and CD8 T cell activation, transient increase in residual viremia, and increase in patients with detectable 2-LTR DNA at week 24 suggest that different events are taking place at the same time and warrants further research.
Thanks! • Hospital Ramón y Cajal • Santiago Moreno • Carolina Gutiérrez • Alex Vallejo • Nadia Madrid • María Abad • Esther Domínguez • Carmen Page • Jose L. Casado • Fernando Dronda • Ana Moreno • M. Jesús Pérez Elías • Paloma Martí-Belda • María Pumares • Javier Zamora • H. Gregorio Marañón • M. Angeles Muñoz • Laura Díaz • Raquel Lorente • KarolinskaInstitute • Sarah Palmer • ViktorDahl • H. 12 Octubre • Rafael Rubio • Pfizer Inc. • Hernán Valdez • Ourpatients!