HIV-1 DNA predicts disease progression and post-treatment virological control.
Williams JP., Hurst J., Stöhr W., Robinson N., Brown H., Fisher M., Kinloch S., Cooper D., Schechter M., Tambussi G., Fidler S., Carrington M., Babiker A., Weber J., Koelsch KK., Kelleher AD., Phillips RE., Frater J., SPARTACTrial Investigators None.
In HIV-1 infection, a population of latently infected cells facilitates viral persistence despite antiretroviral therapy (ART). With the aim of identifying individuals in whom ART might induce a period of viraemic control on stopping therapy, we hypothesised that quantification of the pool of latently infected cells in primary HIV-1 infection (PHI) would predict clinical progression and viral replication following ART. We measured HIV-1 DNA in a highly characterised randomised population of individuals with PHI. We explored associations between HIV-1 DNA and immunological and virological markers of clinical progression, including viral rebound in those interrupting therapy. In multivariable analyses, HIV-1 DNA was more predictive of disease progression than plasma viral load and, at treatment interruption, predicted time to plasma virus rebound. HIV-1 DNA may help identify individuals who could safely interrupt ART in future HIV-1 eradication trials.