Læknablaðið - 15.06.1998, Page 33

LÆKNABLAÐIÐ 1998; 84
483
Mælingar á magni alnæmisveiru í
plasma HIV smitaðra á íslandi
Gunnar Gunnarsson”21, Barbara Stanzeit”, Haraldur Briem31, Hugrún Ríkarðsdóttir31, Már
Kristjánsson3’, Sigurður Guðmundsson2’, Sigurður B. Þorsteinsson21, Arthur Löve”
Gunnarsson G, Stanzeit B, Briem H, Ríkarðsdótt-
ir H, Kristjánsson M, Guðmundsson S, Þorsteins-
son SB, Löve A
Measurements of plasma HIV-1 RNA in Iceland
Læknablaðið 1998; 84: 483-9
Objective: First to measure plasma HlV-1 RNA in
Icelandic HIV infected individuals and second to
evaluate the initial effects of new combination
regimens on viral load and CD4+ cell counts in HIV
infected patients in Iceland.
Material and methods: The cohort studied consis-
ted of all HIV infected individuals we received
samples from during the period September 1995 to
November 1996. HIV-1 RNA and CD4+ cells were
measured initially and subsequently every three to
six months except when a change was made in the
antiretroviral regimen, when samples were measured
before the change, three to four weeks later and then
every three to six months. The quantitative measure-
ment of viral RNA was performed using the Amp-
licor HIV Monitor™ Test (Roche Diagnostic Sys-
tems). CD4+ cell counts were measured by flow cy-
tometry.
Results: A total of 44 patients were evaluated. The
initial RNA ranged from < 2.6 logio to 6.13 logiowith
a mean of 5.02 log. CD4+ cell counts ranged from 2
to 641 per mm’ (mean 230 cells/mm3). Eleven pati-
ents had never been treated with antiretroviral drugs
and had greater than 10 000 viral copies per mL of
plasma. Twenty five of the patients were evaluated
following a change in or initiation of a new treat-
Frá '‘rannsóknastofu Landspítalans í veirufræði, 2llyflækn-
ingadeild Landspítalans, 3lsmitsjúkdómadeild Sjúkrahúss
Reykjavíkur.
Lykilorð: HIV sýking, HIV-1 RNA mælingar íplasma, fjöl-
lyfjameðferð.
ment. The initial change in treatment led to a +0.7 to
-2.88 log change in plasma RNA (mean -0.9 log) and
a mean of 6.9 cells per mm3 increase in CD4+ cells.
Saquinavir was added to two reverse transcriptase
(RT) inhibitors in 11 patients with a resulting mean
of 0.23 log fall in RNA levels (range +0.70 log to
-0.78 log). Saquinavir plus one RT inhibitor were
added to one RT inhibitor in six patients with a
subsequent mean of 0.65 log reduction in viral load
(range +0.24 to -2.26 log). Saquinavir plus two RT
inhibitors were given to four antiretroviral naive
patients with a resulting mean of 2.37 log reduction
in viral load (range -1.8 log to -2.67 log).
Conclusions: 1. In a mixed cohort of RT inhibitor
naive and treated patients, the viral RNA ranged
throughout the range of the RNA assay. 2. Changes
in viral load following changes in treatment were
quite variable. 3. Saquinavir alone added to two RT
inhibitors did not lead to a significant reduction in
viral load. 4. In antiretroviral naive patients the viral
load was reduced 100 fold following treatment with
saquinavir and two RT inhibitors.
Correspondence: Gunnar Gunnarsson, Dpt. of Medical
Virology and Internal Medicine, Landspítalinn/National
University Hospital, 101 Reykjavík, lceland. E-mail:
gunnarbg@rsp.is
Key words: HIV infection, plasma HIV-1 RNA, antiretro-
viral treatment.
Ágrip
Markmið: Annars vegar að mæla HIV-1
(human immunodeficiency virus) RNA í
plasma HIV sýktra einstaklinga á íslandi og
hins vegar að meta áhrif nýrra lyfjasamsetn-
inga á magn veiru í plasma og fjölda CD4+
frumna í blóði.
Aðferðir: Fylgst var með öllum HIV sýktum
einstaklingum sem sýni bárust frá á tímabilinu
september 1995 til nóvember 1996. Blóð var
dregið til mælinga á RNA í plasma og oftast