Rapid viral rebound after analytical treatment interruption in patients with very small HIV reservoir and minimal on-going viral transcription
| العنوان: | Rapid viral rebound after analytical treatment interruption in patients with very small HIV reservoir and minimal on-going viral transcription |
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| المؤلفون: | Ward De Spiegelaere, Joeri L. Aerts, Guido Vanham, Natacha Herssens, Coca Nescoi, Basiel Cole, Linos Vandekerckhove, Eric Florence, Marie-Angélique De Scheerder, Marie-Madeleine Couttenye, Sofie Rutsaert, Sabine Allard, Stéphane De Wit, Pieter Pannus, Achilleas Tsoumanis |
| المساهمون: | Medical Genetics, Clinical sciences, Internal Medicine, Pathologic Biochemistry and Physiology, Pharmaceutical and Pharmacological Sciences, Laboratory of Molecullar and Cellular Therapy |
| المصدر: | JOURNAL OF THE INTERNATIONAL AIDS SOCIETY Journal of the International AIDS Society |
| بيانات النشر: | International AIDS Society, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | CD4-Positive T-Lymphocytes, Male, Viral rebound, viral reservoir, Transcription, Genetic, Human immunodeficiency virus (HIV), HIV Infections, Virus Replication, medicine.disease_cause, 0302 clinical medicine, ANTIRETROVIRAL THERAPY, Transcription (biology), Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Research Articles, treatment interruption, Remission Induction, Middle Aged, Viral Load, TIME, PREDICTS, Infectious Diseases, PCR, Female, post-treatment control, 0305 other medical science, Viral load, Research Article, Adult, medicine.medical_specialty, MAINTAINS, Peripheral blood mononuclear cell, DNA LEVEL, 03 medical and health sciences, Internal medicine, Humans, Adverse effect, cell-associated HIV RNA, 030505 public health, business.industry, Public Health, Environmental and Occupational Health, post‐treatment control, cell‐associated HIV RNA, RNA, HIV, Treatment interruption, DNA, Viral, CELLS, HIV-1, Leukocytes, Mononuclear, Human medicine, business, total HIV DNA |
| الوصف: | Introduction Viral remission after analytical treatment interruption (ATI), termed post-treatment control, has been described in a small proportion of HIV-positive patients. This phenomenon has been separately associated to both low levels of HIV-1 proviral DNA as well as cell-associated RNA. We investigated whether the combination of both parameters could help predict delayed viral rebound after treatment interruption (TI). Methods We conducted an open single-arm ATI study in four Belgian HIV reference centres from January 2016 to July 2018. Eligible participants were adults who had fewer than 50 HIV-1 RNA copies/mL for more than two years, more than 500 CD4 cells/mu L for more than three months, and were in general good health. Consenting participants who had fewer than 66 copies total HIV-1 DNA (t-DNA) and fewer than 10 copies cell-associated HIV-1 unspliced RNA (US-RNA) per million peripheral blood mononuclear cells (PBMCs), interrupted therapy and were monitored closely. Antiretroviral therapy (ART) was resumed after two consecutive viral loads exceeding 1000 copies or one exceeding 10,000 copies/mL. The primary outcome was the proportion of participants with fewer than 50 HIV-1 RNA copies/mL 48 weeks after TI. Secondary outcomes were time to viral rebound, the frequency of serious adverse events (AEs) and evolution of t-DNA and US-RNA after TI. Results All 16 consenting participants who interrupted therapy experienced rapid viral rebound two to eight weeks after TI. No serious AEs were observed. Levels of t-DNA and US-RNA increased after TI but returned to pre-ATI levels after treatment restart. None of the studied demographic, clinical and biological parameters were predictive of time of viral rebound. Conclusions The combination of low levels of t-DNA and US-RNA in PBMCs, corresponding respectively to a small and transcriptionally silent viral reservoir, is not predictive of viral remission after TI in patients on ART. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1758-2652 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::df70bcaa0c8eacc1d5b570a6b0ad6802Test https://doi.org/10.1002/jia2.25453Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....df70bcaa0c8eacc1d5b570a6b0ad6802 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17582652 |
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