Effect of hemodialysis and antiretroviral therapy on plasma viral load in HIV-1 infected hemodialysis patients

T. S. Ahuja, N. Niaz, A. Velasco, B. Watts, D. Paar

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background: Plasma viral load has become an important test in predicting the progress of HIV-1 infected patients. The higher the viral load the faster is the progression to AIDS. As HIV-1 infected hemodialysis (HD) patients have higher mortality and morbidity than HIV-1 infected non-dialysis patients, and as all the blood tests in the HD patients are drawn during HD, we measured the effect of HD and antiretroviral therapy on viral load in HIV-1 infected HD patients. Patients and methods: We measured plasma viral load pre-dialysis and post-dialysis in 10 HIV-1 infected HD patients. The viral load was measured using an in vitro quantitative nucleic acid amplification test. We also compared viral load in 8 HIV-1 infected HD patients on one antiretroviral drug with 8 HIV-1 patients on two (6) or three (2) antiretroviral drugs. Results: There was a small reduction in plasma viral load postdialysis in all HIV-1 infected HD patients (45% ± 5.4, 0.3 log ± 0.05, p < 0.0004). However, HIV-1 RNA could not be detected in the ultrafiltrate. The patients who were on two or three antiretroviral drugs had lower viral load (8915 ± 3702 vs. 351440 ± 101237, p < 0.004) and higher CD4 count (355 ± 81 vs 82 ± 39, p < 0.009) than patients on only one antiretroviral drug. Conclusion: We conclude that there is a small reduction in plasma viral load in HIV-1 infected hemodialysis patients post-dialysis. As no viral RNA could be detected in the ultrafiltrate, the reduction could be due to nonspecific adsorption of the viral RNA to the dialysis membrane. HIV-1 infected hemodialysis patients who are on two or three antiretroviral drugs had significantly lower viral load and higher CD4 count than patients on only single antiretroviral drug. Therefore a single antiretroviral drug should not be used in treating HIV-1 infected HD patients.

Original languageEnglish (US)
Pages (from-to)40-44
Number of pages5
JournalClinical Nephrology
Volume51
Issue number1
StatePublished - Jan 20 1999

Keywords

  • Antiretroviral drugs
  • HIV
  • Hemodialysis
  • Plasma viral load

ASJC Scopus subject areas

  • Nephrology

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