Rectal cell-associated HIV-1 RNA: a new marker ready for the clinic.

Gut-associated lymphoid tissue is a huge reservoir for HIV-1. Developing new strategies to target "residual" HIV-1 in patients on effective therapy brings the need for an evaluation of tissue reservoirs in the clinic. We measured cell-associated HIV-1 RNA and DNA in blood and rectal biopsies from 23 patients, including 14 with undetectable viremia on HAART, by using an adaptation of commercially available tests.

Metabolic evaluation of HIV-infected patients receiving a regimen containing lopinavir/ritonavir (Kaletra).

Purpose: We have analyzed retrospectively the evolution of metabolic parameters in a cohort of 159 HIV-infected patients taking a lopinavir/ritonavir-containing regimen during a mean period of 15 months.

Method: This study was completed by an additional evaluation after strict 12 hours fasting of total cholesterol (TC), HDL-c, LDL-c, triglycerides (TG), glucose, and insulin levels in a subset of 100 patients from the cohort.

Results: TC and TG levels increased early after introduction of lopinavir/ritonavir, but remained subsequently stable.

Discrepancies between protease inhibitor concentrations and viral load in reservoirs and sanctuary sites in human immunodeficiency virus-infected patients.

The variable penetration of antiretroviral drugs into sanctuary sites may contribute to the differential evolution of human immunodeficiency virus (HIV) and the emergence of drug resistance. We evaluated the penetration of indinavir, nelfinavir, and lopinavir-ritonavir (lopinavir/r) in the central nervous system, genital tract, and lymphoid tissue and assessed the correlation with residual viral replication. Plasma, cerebrospinal fluid (CSF), semen, and lymph node biopsy samples were collected from 41 HIV-infected patients on stable highly active antiretroviral therapy regimens to determine drug concentrations and HIV RNA levels.

The HYDILE trial: efficacy and tolerance of a quadruple combination of reverse transcriptase inhibitors versus the same regimen plus hydroxyurea or hydroxyurea and interleukin-2 in HIV-infected patients failing protease inhibitor-based combinations.

Purpose: To compare the efficacy and tolerance of a stavudine (d4T), didanosine (ddI), efavirenz (EFV), and abacavir (ABC) combination regimen with an identical regimen plus hydroxyurea (HU), or plus HU and interleukin-2 (IL-2), in patients failing protease inhibitor-based combinations and naive of EFV and ABC.

Method: This was a randomized prospective trial in 69 HIV-infected patients recruited in one clinical center. Antiretroviral drugs were administered at standard doses according to weight.

Differences in the detection of three HIV-1 protease inhibitors in non-blood compartments: clinical correlations.

Purpose: To study the presence of three HIV-1 protease inhibitors (PIs) in the cerebrospinal fluid (CSF), semen, and lymph nodes and to assess the correlations with residual viral replication in these compartments.

Method: We performed a cross-sectional analysis of sanctuary samples from 41 HIV-infected patients on stable highly active antiretroviral therapy (HAART) regimens containing indinavir, nelfinavir, or lopinavir combined with ritonavir (lopinavir/r) and a longitudinal analysis of PI levels and HIV-1 RNA in plasma and CSF of 6 additional patients on nelfinavir or lopinavir/r monotherapy (3 cases each). Plasma, CSF, semen, and a lymph node (LN) biopsy were taken on the same day.