دورية أكاديمية
Virological remission after antiretroviral therapy interruption in female African HIV seroconverters.
| العنوان: | Virological remission after antiretroviral therapy interruption in female African HIV seroconverters. |
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| المؤلفون: | Gossez, M, Martin, GE, Pace, M, Ramjee, G, Premraj, A, Kaleebu, P, Rees, H, Inshaw, J, Stöhr, W, Meyerowitz, J, Hopkins, E, Jones, M, Hurst, J, Porter, K, Babiker, A, Fidler, S, Frater, J, SPARTAC Trial Investigators |
| المساهمون: | Imperial College Healthcare NHS Trust- BRC Funding, Medical Research Council (MRC), St Marys Development Trust |
| المصدر: | 197 ; 185 |
| سنة النشر: | 2019 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, Virology, Africa, antiretroviral therapy, HIV, posttreatment control, remission, treatment interruption, BLOOD MONONUCLEAR-CELLS, DISEASE PROGRESSION, SUBTYPE-C, RNA LEVELS, TYPE-1 INFECTION, VIRAL LOAD, ACTIVATION, COUNT, DNA, INDIVIDUALS, SPARTAC Trial Investigators, 06 Biological Sciences, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences |
| جغرافية الموضوع: | England |
| الوصف: | INTRODUCTION: There are few data on the frequency of virological remission in African individuals after treatment with antiretroviral therapy (ART) in primary HIV infection (PHI). METHODS: We studied participants (n = 82) from South Africa and Uganda in Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion, the first trial of treatment interruption in African individuals with PHI randomized to deferred ART or 48 weeks of immediate ART. All were female and infected with non-B HIV subtypes, mainly C. We measured HIV DNA in CD4 T cells, CD4 cell count, plasma viral load (pVL), cell-associated HIV RNA and T-cell activation and exhaustion. We explored associations with clinical progression and time to pVL rebound after treatment interruption (n = 22). Data were compared with non-African Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion participants. RESULTS: Pretherapy pVL and integrated HIV DNA were lower in Africans compared with non-Africans (median 4.16 vs. 4.72 log10 copies/ml and 3.07 vs. 3.61 log10 copies/million CD4 T cells, respectively; P < 0.001). Pre-ART HIV DNA in Africans was associated with clinical progression (P = 0.001, HR per log10 copies/million CD4 T cells increase (95% CI) 5.38 (1.95-14.79)) and time to pVL rebound (P = 0.034, HR per log10 copies/ml increase 4.33 (1.12-16.84)). After treatment interruption, Africans experienced longer duration of viral remission than non-Africans (P < 0.001; HR 3.90 (1.75-8.71). Five of 22 African participants (22.7%) maintained VL less than 400 copies/ml over a median of 188 weeks following treatment interruption. CONCLUSION: We find evidence of greater probability of virological remission following treatment interruption among African participants, although we are unable to differentiate between sex, ethnicity and viral subtype. The finding warrants further investigation. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | AIDS; http://hdl.handle.net/10044/1/69487Test; https://dx.doi.org/10.1097/QAD.0000000000002044Test; RDA02 79560; MR/L00528X/1; N/A; RDA02 |
| DOI: | 10.1097/QAD.0000000000002044 |
| الإتاحة: | https://doi.org/10.1097/QAD.0000000000002044Test http://hdl.handle.net/10044/1/69487Test |
| حقوق: | © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under theterms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform,and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
| رقم الانضمام: | edsbas.BA6C4B2B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/QAD.0000000000002044 |
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