Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 440021
Title Modest Nonadherence to Antiretroviral Therapy Promotes Residual HIV-1 Replication in the Absence of Virological Rebound in Plasma
Author(s) Pasternak, A.O.; Bruin, M. de; Jurriaans, S.; Bakker, M.; Berkhout, B.; Prins, J.M.; Lukashov, V.V.
Source The Journal of Infectious Diseases 206 (2012)9. - ISSN 0022-1899 - p. 1443 - 1452.
Department(s) Strategic Communication
Publication type Refereed Article in a scientific journal
Publication year 2012
Keyword(s) protease inhibitor therapy - highly sensitive methods - t-cell-activation - infected individuals - viral suppression - immune activation - drug-resistance - viremia blips - adherence - rna
Abstract Background. Modern antiretroviral therapy (ART) regimens are widely assumed to be forgivable to modest non-adherence, as virological suppression in plasma is common at adherence levels >70%. Yet, it is unknown whether HIV-1 replication is completely suppressed at these levels of adherence. Methods. We longitudinally quantified levels of cell-associated HIV-1 RNA and DNA in forty patients (median time on successful ART before the study initiation, 46 months), whose one-week adherence to therapy prior to the sampling moments was measured electronically. Results. Patients were either constantly 100% adherent, demonstrated improving adherence in time, or neither of the above (“poor adherers”). Adherence never fell below 70% in any patient, and no virological rebound in plasma was observed. Nevertheless, poor adherence, but not optimal or improving adherence, caused a significant longitudinal increase in cell-associated HIV RNA levels (P=0.006). Time-weighted changes and regression slopes of viral RNA were significantly higher in poor adherers than in optimal adherers (P
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