A Randomized Study of the Utility of Human Immunodeficiency Virus RNA Measurement for the Management of Antiretroviral Therapy

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Abstract
To compare frequent measurement with infrequent measurement of human immunodeficiency virus (HIV) RNA levels in the management of antiretroviral therapy, we conducted a clinical strategy study of 206 HIV-infected patients who had 3. Patients were randomized (1.5 : 1) to undergo frequent monitoring (at baseline and every 2 months) or infrequent monitoring (at baseline and twice yearly), with CD4 cell counts determined every 2 months. Patients received unrestricted antiretroviral therapy. In the primary analysis (at month 6), the frequent group had a mean HIV RNA reduction (± standard deviation) of 0.93 ± 0.79 log10 copies/mL, versus 0.48 ± 0.83 log10 copies/mL for the infrequent group (P = .0002). A trend (P = .1) toward improved survival was seen in the frequent group. Given this iproved virological response, more frequent HIV RNA measurement than is recommended in published guidelines (every 3–4 months) may be appropriate.