Factors associated with a low HIV reservoir in patients with prolonged suppressive antiretroviral therapy
S Fourati, P Flandre, R Calin… - Journal of …, 2014 - academic.oup.com
Journal of Antimicrobial Chemotherapy, 2014•academic.oup.com
Objectives The relevance of low-level HIV DNA in patients who have undergone prolonged
therapy is not well understood. The objective of this study was to determine factors that
influence the establishment of low-level HIV DNA in long-term treated patients (excluding
treatment since acute infection). Methods This was a cross-sectional study involving 243
patients receiving highly active antiretroviral therapy (HAART) for≥ 6 months (median: 9
years of treatment) with plasma HIV RNA< 50 copies/mL at the study timepoint, for whom …
therapy is not well understood. The objective of this study was to determine factors that
influence the establishment of low-level HIV DNA in long-term treated patients (excluding
treatment since acute infection). Methods This was a cross-sectional study involving 243
patients receiving highly active antiretroviral therapy (HAART) for≥ 6 months (median: 9
years of treatment) with plasma HIV RNA< 50 copies/mL at the study timepoint, for whom …
Objectives
The relevance of low-level HIV DNA in patients who have undergone prolonged therapy is not well understood. The objective of this study was to determine factors that influence the establishment of low-level HIV DNA in long-term treated patients (excluding treatment since acute infection).
Methods
This was a cross-sectional study involving 243 patients receiving highly active antiretroviral therapy (HAART) for ≥6 months (median: 9 years of treatment) with plasma HIV RNA <50 copies/mL at the study timepoint, for whom total DNA measurements were performed. Patients treated since early acute infection or receiving cancer chemotherapeutic/immunosuppressive agents were excluded from the study.
Results
Overall, the median HIV DNA was 372 copies/106 peripheral blood mononuclear cells (PBMCs). Forty-seven patients had levels of HIV DNA below the limit of detection and 58 patients had low-level HIV DNA (<100 copies/106 PBMCs). In multivariate analysis, a low total HIV DNA in HAART-treated patients was clearly associated with a low HIV RNA pre-therapeutic viral load (P < 0.0001), regardless of the cut-off used.
Conclusions
These results may be helpful to identify candidates for future trials aiming at a functional cure of HIV infection, since low total HIV DNA levels will most likely be a prerequisite of successful immunological control of HIV replication.
Oxford University Press