HIV Expression in Patients With Low Viral Load on Highly Active Antiretroviral Therapy (HAART)

Inclusion Criteria

• •HIV-1 infection documented by HIV ELISA and WB
• •Age greater than or equal to 18 years old
• •Hemoglobin greater than or equal to 12 mg/dl within the last six weeks
• •On HAART according to current DHHS guidelines.
• •Most recent viral load (within the last 12 weeks):
• •* less than 50 by bDNA or RT-PCR (65 patients)
• •* 50-500 by bDNA or RT-PCR (3 patients)
• •* 501 - 10,000 by bDNA or RT-PCR (2 patients)
• •HIV-1 infection documented by HIV ELISA and WB
• •Age greater than or equal to 18 years old
• •Hgb greater than or equal to 12 mg/dl
• •CD4 greater than 200 cells/ micro liter and CD4% greater than 14% and not requiring prophylaxis for opportunistic infections
• •Therapy with accept HAART regimen for greater than or equal to 6 months
• •Viral load less than 50 copies RNA/ml plasma by RT-PCR for at least four months
• •Viral load greater than 0.38 copies RNA/ml plasma by SCA assay or positive in the adapted Amplicor assay
• •Current HAART with DHHS-approved regimen NRTI+PI, NRTI alone, NRTI+NNRTI.
• •Willingness to take an additional antiretroviral to current regimen for 30 days.
• •For patients to start lopinavir/ritonavir, willingness to reduce the dose of sildenafil and other co-administered medicines that may be affected by the addition of lopinavir/ritonavir during the course of therapy with lopinavir/ritonavir
• •For patients to start efavirenz arm, willingness to take efavirenz and adjust other medications or supplements as necessary, and to be aware that efavirenz is contraindicated in pregnancy and that may result in false positive urine tests for THC
• •For patients starting raltegravir, no prior history of rhabdomyolysis and no co-administration of agents which, in the opinion of the investigators, would cause rhabodomyolysis or myopathy.
• •Patient must have primary care outside this protocol.
• •Patients must practice accepted barrier methods to prevent pregnancy.
• •For patients enrolled in piolt study of suppression after development of resistance, patient must have documented evidence of prior drug resistance either: Prior resisteance testing with the presence of resisnce mutations or documents evidence of viral RNA levels greater than 100 copies/ml plasma for greater than 6 months despite antiretroviral thereapy. Patients with prior therapy on monotherapy or suboptimal combination therapy ARE eligible for this study.
• •HIV-1 infection documented by HIV ELISA and WB
• •Age greater than or equal to 18 years old
• •Hgb greater than or equal to 12 mg/dl
• •CD4 greater than 200 cells/ micro liter and CD4% greater than 14% and not requiring prophylaxis for opportunistic infections
• •Therapy with accepted HAART regimen for greater than or equal to 6 months.
• •Viral load less than 50 copies RNA /ml plasma by RT-PCR for at least four months.
• •Viral load greater than or equal to 0.38 copies RNA/ml plasma by SCA assay or positive in the adapted Amplicor assay
• •Current HAART with DHHS-approved regimen NRTI+PI, NRTI alone, NRTI+NNRTI.
• •Willingness to take an additional antiretroviral to current regimen for 30 days.
• •For patients to start lopinavir/ritonavir, willingness to reduce the dose of sildenafil and other co-administered medicines that may be affected by the addition of lopinavir/ritonavir during the course of therapy with lopinavir/ritonavir
• •For patients to start efavirenz arm, willingness to take efavirenz and adjust other medications or supplements as necessary, and to be aware that efavirenz is contraindicated in pregnancy and that may result in false positive urine tests for THC
• •Patient must have primary care outside this protocol.
• •Patients must practice accepted barrier methods to prevent pregnancy.
• •HIV-1 infection documented by HIV ELISA and WB
• •Age greater than or equal to18 years old
• •Hgb greater than or equal to 12 mg/dl
• •CD4 greater than 200 cells/ micro liter and CD4% greater than 14% and not requiring prophylaxis for opportunistic infections
• •Therapy with accepted HAART regimen for greater than or equal to 6 months
• •Viral load less than 50 copies RNA/ml plasma by RT-PCR for at least four months
• •Viral load greater than 0.38 copies RNA/ml plasma by SCA assay or positive in the adapted Amplicor assay
• •Current HAART with DHHS-approved regimen NRTI+PI, NRTI alone, NRTI+NNRTI
• •Willingness to take an additional antiretroviral to current regimen for 30 days
• •For patients planning to start lopinavir/ritonavir, or other ritonavir containing regimen willingness to reduce the dose of sildenafil and other co-administered medicines that may be affected by the addition of ritonavir during the course of therapy with lopinavir/ritonavir
• •For patients to start efavirenz, willingness to take efavirenz and adjust other medications or supplements as necessary, and to be aware that efavirenz is contraindicated in pregnancy and that may result in false positive urine tests for THC
• •Patient must have primary care outside this protocol
• •Patients must practice accepted barrier methods to prevent pregnancy.