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Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection
OBJECTIVE(S): An HIV cure will impose aviraemia that is sustained following the withdrawal of antiretroviral therapy (ART). Understanding the efficacy of novel interventions aimed at curing HIV requires characterization of both natural viral control and the effect of ART on viral control after treat...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278888/ https://www.ncbi.nlm.nih.gov/pubmed/28060012 http://dx.doi.org/10.1097/QAD.0000000000001382 |
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author | Martin, Genevieve E. Gossez, Morgane Williams, James P. Stöhr, Wolfgang Meyerowitz, Jodi Leitman, Ellen M. Goulder, Philip Porter, Kholoud Fidler, Sarah Frater, John |
author_facet | Martin, Genevieve E. Gossez, Morgane Williams, James P. Stöhr, Wolfgang Meyerowitz, Jodi Leitman, Ellen M. Goulder, Philip Porter, Kholoud Fidler, Sarah Frater, John |
author_sort | Martin, Genevieve E. |
collection | PubMed |
description | OBJECTIVE(S): An HIV cure will impose aviraemia that is sustained following the withdrawal of antiretroviral therapy (ART). Understanding the efficacy of novel interventions aimed at curing HIV requires characterization of both natural viral control and the effect of ART on viral control after treatment interruption. DESIGN: Analysis of transient viral control in recent seroconverters in the Short Pulse AntiRetroviral Therapy at Acute Seroconversion trial. METHODS: We compared untreated and treated HIV seroconverters (n = 292) and identified periods of control (plasma HIV RNA < 400 copies/ml for ≥16 weeks off therapy) in 7.9% of ART-naive participants, and in 12.0% overall. HIV DNA was measured by qPCR, and HIV-specific CD8(+) responses were measured by enzyme-linked immunosorbent spot assay (ELISpot). T-cell activation and exhaustion were measured by flow cytometry. RESULTS: At baseline, future controllers had lower HIV DNA, lower plasma HIV RNA, higher CD4(+) : CD8(+) ratios (all P < 0.001) and higher CD4(+) cell counts (P < 0.05) than noncontrollers. Among controllers, the only difference between the untreated and those who received ART was higher baseline HIV RNA in the latter (P = 0.003), supporting an added ART effect. CONCLUSION: Consideration of spontaneous remission in untreated individuals will be critical to avoid overestimating the effect size of new interventions used in HIV cure studies. |
format | Online Article Text |
id | pubmed-5278888 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-52788882017-02-08 Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection Martin, Genevieve E. Gossez, Morgane Williams, James P. Stöhr, Wolfgang Meyerowitz, Jodi Leitman, Ellen M. Goulder, Philip Porter, Kholoud Fidler, Sarah Frater, John AIDS Basic Science: Concise Communication OBJECTIVE(S): An HIV cure will impose aviraemia that is sustained following the withdrawal of antiretroviral therapy (ART). Understanding the efficacy of novel interventions aimed at curing HIV requires characterization of both natural viral control and the effect of ART on viral control after treatment interruption. DESIGN: Analysis of transient viral control in recent seroconverters in the Short Pulse AntiRetroviral Therapy at Acute Seroconversion trial. METHODS: We compared untreated and treated HIV seroconverters (n = 292) and identified periods of control (plasma HIV RNA < 400 copies/ml for ≥16 weeks off therapy) in 7.9% of ART-naive participants, and in 12.0% overall. HIV DNA was measured by qPCR, and HIV-specific CD8(+) responses were measured by enzyme-linked immunosorbent spot assay (ELISpot). T-cell activation and exhaustion were measured by flow cytometry. RESULTS: At baseline, future controllers had lower HIV DNA, lower plasma HIV RNA, higher CD4(+) : CD8(+) ratios (all P < 0.001) and higher CD4(+) cell counts (P < 0.05) than noncontrollers. Among controllers, the only difference between the untreated and those who received ART was higher baseline HIV RNA in the latter (P = 0.003), supporting an added ART effect. CONCLUSION: Consideration of spontaneous remission in untreated individuals will be critical to avoid overestimating the effect size of new interventions used in HIV cure studies. Lippincott Williams & Wilkins 2017-02-20 2017-02-01 /pmc/articles/PMC5278888/ /pubmed/28060012 http://dx.doi.org/10.1097/QAD.0000000000001382 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | Basic Science: Concise Communication Martin, Genevieve E. Gossez, Morgane Williams, James P. Stöhr, Wolfgang Meyerowitz, Jodi Leitman, Ellen M. Goulder, Philip Porter, Kholoud Fidler, Sarah Frater, John Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title_full | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title_fullStr | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title_full_unstemmed | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title_short | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
title_sort | post-treatment control or treated controllers? viral remission in treated and untreated primary hiv infection |
topic | Basic Science: Concise Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278888/ https://www.ncbi.nlm.nih.gov/pubmed/28060012 http://dx.doi.org/10.1097/QAD.0000000000001382 |
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