J Antimicrob Chemother. 2015 Jul;70(7):2108-20. doi: 10.1093/jac/dkv084.

Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission.

 

Chéret A, Bacchus-Souffan C, Avettand-Fenoël V, Mélard A, Nembot G, Blanc C, Samri A, Sáez-Cirión A, Hocqueloux L, Lascoux-Combe C, Allavena C, Goujard C, Valantin MA, Leplatois A, Meyer L, Rouzioux C, Autran B; OPTIPRIM ANRS-147 Study Group.

Corresponding author:

Laboratoire de Virologie, Hôpital Necker EA 7327, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France. E-mail: antoinecheret@free.fr

 

Abstract

BACKGROUND:

Therapeutic control of HIV replication reduces the size of the viral reservoir, particularly among central memory CD4+ T cells, and this effect might be accentuated by early treatment.

METHODS:

We examined the effect of ART initiated at the time of the primary HIV infection (early ART), lasting 2 and 6 years in 11 and 10 patients, respectively, on the HIV reservoir in peripheral resting CD4+ T cells, sorted into naive (TN), central memory (TCM), transitional memory (TTM) and effector memory (TEM) cells, by comparison with 11 post-treatment controllers (PTCs).

RESULTS:

Between baseline and 2 years, CD4+ T cell subset numbers increased markedly (P < 0.004) and HIV DNA levels decreased in all subsets (P < 0.009). TTM cells represented the majority of reservoir cells at both timepoints, T cell activation status normalized and viral diversity remained stable over time. The HIV reservoir was smaller after 6 years of early ART than after 2 years (P < 0.019), and did not differ between PTCs and patients treated for 6 years. One patient, who had low reservoir levels in all T cell subsets after 2 years of treatment similar to the levels in PTCs, spontaneously controlled viral replication during 18 months off treatment.

CONCLUSIONS:

Early prolonged ART thus limits the size of the HIV reservoir, protects long-lived cells from persistent infection and may enhance post-treatment control.

KEYWORDS:

HIV DNA; post-treatment controllers; primary HIV infections; reservoirs

PMID: 25900157

 

 

 

 

 

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