The SMART Study: CD4-Cell Count and Viral Load Account for Inferiority of Episodic ART

The higher risk for opportunistic disease or death observed in the episodic-treatment group was linked to both time spent with a lower CD4-cell count and time with uncontrolled HIV replication.

In the SMART study, 5472 HIV-infected patients with baseline CD4 counts >350 cells/mm³ were randomized to receive either episodic antiretroviral therapy (ART) based on CD4-cell count or continuous ART. As previously reported (ACC Nov 29 2006), the episodic-treatment group had a higher rate of opportunistic disease or death than did the continuous-therapy group (3.3 vs. 1.3 per 100 person-years), leading to early termination of the study. Now, investigators have further explored the reasons for the inferiority of episodic treatment, focusing specifically on CD4-cell counts and viral loads during follow-up (mean, 16 months).

Compared with the continuous-therapy group, the episodic-treatment group spent a greater proportion of follow-up time wi…

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

The SMART Study: CD4-Cell Count and Viral Load Account for Inferiority of Episodic ART

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Reviewing Author