Abstract | OBJECTIVE: The initiation of antiretroviral therapy (ART) during primary infection may offer clinical benefits for HIV-infected individuals by reducing HIV DNA reservoir size and chronic T-cell activation. Current evidence for the advantages of early ART, however, are mostly derived from cross-sectional studies, with the long-term benefits yet to be ascertained. DESIGN/METHODS: We conducted an open-label, nonrandomized study, monitoring for 3 years: plasma viral load (pVL), T-cell phenotypes, and peripheral CD4(+) T-cell associated total, integrated and 2-long terminal repeat HIV DNA species. The study included 16 treatment-naive individuals initiating ART with raltegravir and Truvada during either primary (PHI, n = 8) or chronic (CHI, n = 8) HIV infection. RESULTS: ART initiated during PHI compared with CHI generated significant reductions of peripheral CD4(+) T-cell HIV DNA reservoirs that were sustained for 3 years of therapy. Median log10 HIV DNA copies/10(6) CD4(+) T cells at the final visit: total; CHI = 3.23 > PHI = 2.72, P < 0.01; integrated; CHI = 2.64 > PHI = 1.77, P < 0.01. Similar trends were observed for pVL, however, did not reach significance: log10 HIV RNA copies/ml plasma at the final visit: CHI = 1.3 ≥ PHI = 0.39, P = 0.08. Both cohorts displayed similar and elevated levels of CD38/ HLA-DR coexpression on CD4(+) and CD8(+) T cells relative to uninfected healthy controls. CONCLUSION: The reduction in HIV DNA reservoirs generated by the early initiation of ART was sustained for 3 years of therapy. Although the PHI cohort trended to lower levels of pVL, and pVL was associated with CD8(+) T-cell activation, no differences in T-cell activation were observed between the PHI and CHI groups.
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Authors | William J Hey-Cunningham, John M Murray, Ven Natarajan, Janaki Amin, Cecilia L Moore, Sean Emery, David A Cooper, John Zaunders, Anthony D Kelleher, Kersten K Koelsch, PINT study team |
Journal | AIDS (London, England)
(AIDS)
Vol. 29
Issue 8
Pg. 911-9
(May 15 2015)
ISSN: 1473-5571 [Electronic] England |
PMID | 25730509
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-HIV Agents
- DNA, Viral
- Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
- RNA, Viral
- Raltegravir Potassium
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Topics |
- Anti-HIV Agents
(therapeutic use)
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
(immunology, virology)
- CD8-Positive T-Lymphocytes
(immunology)
- Cohort Studies
- Cross-Sectional Studies
- DNA, Viral
(blood)
- Drug Therapy, Combination
- Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
(therapeutic use)
- HIV Infections
(drug therapy)
- HIV-1
- Humans
- Immunophenotyping
- Lymphocyte Activation
(immunology)
- RNA, Viral
(blood)
- Raltegravir Potassium
(therapeutic use)
- Viral Load
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