Martin, GE;
Gossez, M;
Williams, JP;
Stöhr, W;
Meyerowitz, J;
Leitman, EM;
Goulder, P;
... SPARTAC Trial Investigators, .; + view all
(2017)
Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection.
AIDS
, 31
(4)
pp. 477-484.
10.1097/QAD.0000000000001382.
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Abstract
OBJECTIVE(S): An HIV cure will impose aviraemia which is sustained following the withdrawal of antiretroviral therapy (ART). Understanding the efficacy of novel interventions aimed at curing HIV requires characterisation 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 SPARTAC trial. METHODS: We compared untreated and treated HIV seroconverters (n = 292) and identified periods of control (plasma VL<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 ELISpot. T cell activation and exhaustion were measured by flow cytometry. RESULTS: At baseline, future controllers had lower HIV DNA, lower plasma VLs, higher CD4:CD8 ratios (all p < 0.001), and higher CD4 counts (p < 0.05) than non-controllers. Among controllers, the only difference between the untreated and those who received ART was higher baseline VLs in the latter (p = 0.003), supporting an added ART effect. CONCLUSIONS: Consideration of spontaneous remission in untreated individuals will be critical to avoid overestimating the effect size of new interventions used in HIV cure studies.
| Type: | Article |
|---|---|
| Title: | Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000001382 |
| Publisher version: | http://dx.doi.org/10.1097/QAD.0000000000001382 |
| Language: | English |
| Additional information: | Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. 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. |
| Keywords: | HIV, T lymphocytes, ELISpot, natural history, post-treatment control, antiretroviral therapy, HIV DNA |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1536092 |
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