HIV-1 DNA predicts disease progression and post-treatment virological control

Elife. 2014 Sep 12:3:e03821. doi: 10.7554/eLife.03821.

Abstract

In HIV-1 infection, a population of latently infected cells facilitates viral persistence despite antiretroviral therapy (ART). With the aim of identifying individuals in whom ART might induce a period of viraemic control on stopping therapy, we hypothesised that quantification of the pool of latently infected cells in primary HIV-1 infection (PHI) would predict clinical progression and viral replication following ART. We measured HIV-1 DNA in a highly characterised randomised population of individuals with PHI. We explored associations between HIV-1 DNA and immunological and virological markers of clinical progression, including viral rebound in those interrupting therapy. In multivariable analyses, HIV-1 DNA was more predictive of disease progression than plasma viral load and, at treatment interruption, predicted time to plasma virus rebound. HIV-1 DNA may help identify individuals who could safely interrupt ART in future HIV-1 eradication trials.

Keywords: HIV-1; antiretroviral therapy; cure; human; human biology; infectious disease; medicine; microbiology; primary infection; reservoir.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiretroviral Therapy, Highly Active*
  • Biomarkers
  • CD4 Lymphocyte Count
  • Demography
  • Disease Progression*
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology*
  • HIV-1 / metabolism*
  • Humans
  • Male
  • Proportional Hazards Models
  • RNA, Viral / blood
  • RNA, Viral / metabolism*
  • Time Factors
  • Viral Load
  • Withholding Treatment

Substances

  • Biomarkers
  • RNA, Viral