Perrin L, Rakik A, Yerly S, Baumberger C, Kinloch-de Loës S, Pechère M, Hirschel B
Central Laboratory of Virology, Geneva University Hospital, Switzerland.
AIDS. 1996 Sep;10(11):1233-7. doi: 10.1097/00002030-199609000-00009.
To decrease viraemia levels in primary HIV infection by using a combination of zidovudine (ZDV) and L-697,661.
Four primary HIV-infected patients were treated for 6 months with ZDV, 250 mg twice daily, in association with the non-nucleoside reverse transcriptase inhibitor L-697,661 500 mg three times daily. Viraemia, proviral DNA, CD4 and CD8 cell counts were measured serially during 18 months.
Viraemia decreased to undetectable levels (< 200 RNA copies/ml) in two patients. A third patient had a marked decrease followed by a rebound during therapy; viraemia levels did not vary markedly in the fourth patient. A rebound in viraemia levels was observed within 15 days of discontinuation of therapy in the three responding patients. Proviral levels evolved in parallel with viraemia but were always detectable in all patients. In the three patients with an initial decrease of viraemia, CD4 cell counts were within the normal range 2 months after initiation of therapy and did not markedly decrease after discontinuation of therapy. In the two patients with partial or no response of viraemia, mutations associated with low level of resistance to L-697,661 appeared during treatment.
A marked decrease of viraemia can be achieved in some primary HIV-infected patients with combined therapy. Six months of treatment does not prevent a rebound of viraemia, which was observed within 15 days of interruption of therapy.
通过联合使用齐多夫定（ZDV）和L-697,661降低原发性HIV感染中的病毒血症水平。
4例原发性HIV感染患者接受ZDV治疗6个月，每日2次，每次250mg，同时联合使用非核苷类逆转录酶抑制剂L-697,661，每日3次，每次500mg。在18个月期间连续测量病毒血症、前病毒DNA、CD4和CD8细胞计数。
2例患者的病毒血症降至检测不到的水平（<200 RNA拷贝/ml）。第3例患者在治疗期间病毒血症显著下降，随后出现反弹；第4例患者的病毒血症水平无明显变化。在3例有反应的患者中，停药后15天内观察到病毒血症水平反弹。前病毒水平与病毒血症平行变化，但在所有患者中均始终可检测到。在最初病毒血症下降的3例患者中，治疗开始后2个月CD4细胞计数在正常范围内，停药后未明显下降。在2例病毒血症部分或无反应的患者中，治疗期间出现了与对L-697,661低水平耐药相关的突变。
联合治疗可使部分原发性HIV感染患者的病毒血症显著降低。6个月的治疗不能预防病毒血症的反弹，在治疗中断后15天内观察到了这种反弹。
