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Rapid viral rebound after analytical treatment interruption in patients with very small HIV reservoir and minimal on-going viral transcription

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Show simple item record Pannus, P. en_US Rutsaert, S. en_US De Wit, S. en_US Allard, S. D. en_US Vanham, G. en_US Cole, B. en_US Nescoi, C. en_US Aerts, J. en_US De Spiegelaere, W. en_US Tsoumanis, A. en_US Couttenye, M. M. en_US Herssens, N. en_US De Scheerder, M. A. en_US Vandekerckhove, L. en_US Florence, E. en_US 2020-08-25T09:38:06Z 2020-08-25T09:38:06Z 2020 en_US
dc.identifier.issn 1758-2652 en_US
dc.identifier.doi en_US
dc.identifier.other ITG-B1A; ITG-CxA; MULTI; DBM; U-VIROL; DCS; U-CTU; U-STDCLI; JIF; DOI; CPDF; Abstract; ITMPUB; DSPACE68 en_US
dc.description.abstract 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/microL 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. en_US
dc.language English en_US
dc.relation.uri en_US
dc.subject HIV en_US
dc.subject Viral diseases en_US
dc.subject Treatment interruption en_US
dc.subject Viral rebound en_US
dc.title Rapid viral rebound after analytical treatment interruption in patients with very small HIV reservoir and minimal on-going viral transcription en_US
dc.type Article-E en_US
dc.citation.issue 2 en_US
dc.citation.jtitle Journal of the International AIDS Society en_US
dc.citation.volume 23 en_US
dc.citation.pages e25453 en_US
dc.citation.abbreviation J Int AIDS Soc en_US

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