Document 1111
 DOCN  M94A1111
 TI    2 year follow-up of HIV viremia in patients on ddI.
 DT    9412
 AU    Yerly S; Kaiser L; Hirschel B; Perrin L; Laboratory of Virology, Geneva
       University Hospital, Switzerland.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):206 (abstract no. PB0839). Unique
       Identifier : AIDSLINE ICA10/94371464
 AB    OBJECTIVE: To evaluate the prognostic value of changes in HIV viremia
       after 1 month of ddI therapy. METHODS: Viremia, expressed as log of
       circulating RNA/ml of serum: RT-PCR with external standard. Resistance
       mutation at codons 215 and 74: use of mutation-specific primers for
       selective PCR. RESULTS: After 1 month of ddI therapy, 16/34 (47%)
       patients had significantly (> 60%) decreased viremia (responders).
       Median baseline characteristics were not different between responders
       and nonresponders: viremia 5.64 vs 5.85 (p = 0.9), CD4+/mm3 133 vs 67 (p
       = 0.14). After 1 month of ddI, a significant increase in CD4+ was
       observed (p = 0.001), with no significant difference between the 2
       groups. However, responders had a mean survival time (941 vs 632 days,
       log rank p = 0.025) and a median time free of new AIDS-defining events
       (840 days vs 306, p = 0.017) increased. 20 (59%) patients had 215
       mutation (215M) at the time of ddI initiation. Presence of 215M was
       significantly related to lower initial CD4+ (p = 0.03) whereas relation
       to higher initial viremia was not evident (p = 0.05). 10/14 (71%)
       patients without 215M were responders vs 6/20 (30%) with 215M (p =
       0.02). Mutation at codon 74 developed in 40% of patients by 24 months of
       ddI therapy. Baseline characteristics were similar in patients who
       developed the 74M and those who did not (CD4+: p = 0.9, viremia: p =
       0.8). At the time of appearance of 74M, increasing viremia (p = 0.006)
       and decreasing CD4+ (p = 0.019) were observed. CONCLUSIONS: Decreased
       viremia after 1 month of ddI therapy is linked to delayed disease
       progression. 215M predicts nonresponse to ddI at 1 month. 40% of
       patients developed 74M by 24 months of ddI therapy.
 DE    Didanosine/*THERAPEUTIC USE  Follow-Up Studies  Human  HIV
       Infections/*DRUG THERAPY  Prognosis  Viremia/*DRUG THERAPY  MEETING
       ABSTRACT

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