UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Post-treatment control or treated controllers? Viral remission in treated and untreated primary HIV infection

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. Green open access

[img]
Preview
Text
Porter_00002030-201702200-00006.pdf - Published version

Download (555kB) | Preview

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
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
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
Downloads since deposit
31Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item