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HAART must be taken for life to maintain viral load suppression, improved health, and low infectiousness.
15, 18, 19, 75 Potent second- and third-line regimens with similar characteristics will also be required so that if first-line drug resistance develops in patients, the regimens required to maintain viral load suppression will be readily available.
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All patients but one maintained viral load < 50 copies/ml at 12 months.
This is the first study to indicate a beneficial effect of HLA B∗5701 on achieving and maintaining viral load suppression.
As described in the previous paragraph, accessory and regulatory viral proteins are able to stimulate cell cycle progression thereby maintaining viral load in the host.
The proportion of patients maintaining viral load below 50 copies/ml was similar between treatment arms throughout the study and at week 240 (maraviroc 50.8% vs. efavirenz 45.9%).
The subjects (n=48) in this Phase 3b switching study (NCT01533259, Gilead Study 123) were on raltegravir (bid) therapy (plus FTC/TDF) and maintained viral load below 50 copies/mL for at least 6 months.
For a month, all in the group that got two infusions maintained viral loads that were vanishingly low.
At 48 weeks, 62.1% of the raltegravir group maintained viral loads <50 copies/mL compared with 32.9% of the placebo group (P < 0.001).
The results demonstrated that virtually all patients, ie, greater than 90% of individuals, maintained viral loads < 50 copies/mL at 24 weeks and that individuals in the delayed switch arm of the study also maintained viral loads < 50 copies/mL in over 90% of cases.
Interestingly, 41% of patients with a genotypic sensitivity score (GSS) of '0' maintained viral loads <50 copies/mL at week 96, suggesting that this subset of patients achieved viral suppression essentially on raltegravir monotherapy (Table 3).
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