Long-Term Supervised Treatment Interruption in HIV-Infected Patients

• Proportion of patients who did not resume antiretroviral treatment at 12 months
  

• Time to resume antiretroviral treatment with CD4 cell count equal or below 300/mm3
  
• Proportion of patients who did not resume antiretroviral treatment at M 24 and M 36
  
• Predictive factors associated with the time of restart of antiretroviral therapy: Proviral HIV DNA at baseline and during follow-up
  
• Plasma HIV RNA at baseline and during follow-up
  
• CD4 T cell and CD8 T cell HIV specific responses at baseline and after 12 months
  
• Change in lipodystrophy clinical score and quality of life during the follow-up
  
• Criteria to resume antiretroviral treatment: CD4T cell count below or equal to 300/mm3
  
• The occurrence of an AIDS defining event
  

The limitations of the drugs used against HIV include their toxicity, their tolerability, their propensity to induce resistance when not taken with absolute regularity and their cost. Treatment interruption in patients receiving antiretroviral treatment in the setting of chronic infection are associated with viral rebound and rapid CD4 T cell decrease conducting to antiretroviral therapy restart.

In patients with high CD4+ cell counts (patients receiving treatment of chronic infection with controlled viremia and patients who are receiving HAART now in whom treatment would not have been started based on current guidelines), we evaluated the safety of long term supervised treatment interruption. Another aim of this study was to assess the immunological and virological factors associated with the duration of treatment interruption (proviral HIV DNA at baseline and during follow-up, plasma HIV RNA at baseline and during follow-up, CD4 T cell and CD8 T cell HIV specific responses at baseline and after 12 months).