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Highly active antiretroviral therapy with or without mycophenolate mofetil in treatment-naive HIV-1 patients

Abstract:

Objective: To study the effect of mycophenolate mofetil (MMF) on the decay rate of plasma HIV-1 RNA and the latently infected cellular reservoir in treatment-naive patients starting antiretroviral therapy. Design: Randomized trial. Methods: A group of 19 HIV-1 infected patients (9 with a chronic and 10 with a primary infection) starting a triple antiretroviral drug regimen were randomized to a group with or without MMF. Plasma samples for HIV-1 RNA were taken and HLA-DR− CD4+ T cells were co-cultured for HIV-1 isolation. Slopes of plasma HIV-1 RNA and cellular viral load decay were calculated for the first 14 days and the first 24 weeks of treatment, respectively. Results: The median plasma HIV-1 RNA daily decay rate in chronically infected patients was 0.25 log 10 copies/ml [interquartile range (IQR), 0.18–0.30] with MMF and 0.28 log 10 copies/ml (IQR, 0.22–0.32) without MMF (P= 0.56); in primary infected patients …