Abstract

To evaluate the therapeutic utility of the viral load (VL) measurement after one month (M1) of antiretroviral (ARV) treatment. A retrospective study of HIV patients included in the NADIS database from 1998 to 2006 and followed at Nice University Hospital. We included ARV-naive patients who received ARV (3-drug combination) for at least 3 months and ARV-experienced patients beginning a new ARV after virologic failure. The NADIS database included 1065 patients from 1998 to 2006. We included 262. In all, 234 of them had VL measured at M1 and are considered in this analysis. Their mean age was 44 years, and 174 were men, for a sex ratio of 9.1. ARV-naïve patients accounted for 35% of the sample (n = 81) and previously treated patients 65% (n = 153). All the naive patients had a VL decrease at M1 > 1 log, as did all but 14 of the previously treated patients (9%). This virological result was followed by a medical action 21 times for the naive patients and 97 times for the previously treated patients (p < 0.004). The VL measurement at M1 indicates a virological objective that was reached for all the naive patients and 91% of the previously treated patients. Moreover, the medical actions taken at M1 for a new ARV treatment appear to be associated with the patient's treatment history and not the virological results.

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