Oliver & Co.: I thank you for sharing the latest information on your recent conference.
The issue of new third generation HIV tests that will have a limit of detection of 25 copies/ml. is intriguing.
A question that has remained is whether there is full 100% viral suppression on a three drug combo such as nelfinavir, AZT, and 3TC. I reviewed a paper from Dr. Marty Markowitz and colleages from the Aaron Diamond AIDS Research Center, Rockefeller University, New York; that was presented at the XI th International Conference on AIDS. He reported on the results of a small pilot study of 12 antiretroviral-naive, HIV infected individuals, all with baseline viral loads above 10,000 copies/ml. In these 12 individuals the baseline mean and median viral loads were 209,000 copies/ml. and 81,000 copies/ml., respectively. For this baseline assay, he used a second generation vRNA assay, Chiron's second generation bDNA test with a lower limit of detection of 500 copies/ml. In his 16 week follow up HIV assay, he used the third generation Chiron bDNA test with a lower limit of detection of 25 copies/ml.
His data revealed two individuals with viral loads at baseline of 864,000 and 551,000. Both of these individuals achieved viral loads of 25 copies/ml. or less. Basically they achieved viral suppression to the limit of detection of the third generation test (25 copies/ml.). This indicates and proves a 4.5 log reduction as a minimum. Keep in mind that all of these patients were new to antiretroviral therapy and took their medication faithfully.
The take home message for me is that nelfinavir with combination with AZT and 3TC produced a uniform aviremia after three months or more of uninterrupted therapy. This combination holds the promise of controlling HIV infection in HIV infected individuals.
It is interesting to realize that the third generation tests are showing control of viral replication down to the limit of 25 copies/ml.
This suggests the power of antiretroviral treatment that is available.
Best regards,
TJK. |
