Paradoxically Greater Persistence of HIV RNA-Positive Cells in Lymphoid Tissue When ART Is Initiated in the Earliest Stage of Infection.
Eugène KroonSuthat ChottanapundSupranee BuranapraditkunCarlo SacdalanDonn J ColbyNitiya ChomcheyPeeriya PrueksakaewSuteeraporn PinyakornRapee TrichavarojSandhya VasanSopark ManasnayakornCavan ReillyErika HelgesonJodi AndersonCaitlin DavidJacob ZulkMark de SouzaSodsai TovanabutraAlexandra SchuetzMerlin L RobbDaniel C DouekNittaya PhanuphakAshley HaaseJintanat AnanworanichTimothy W SchackerPublished in: The Journal of infectious diseases (2022)
Starting antiretroviral therapy (ART) in Fiebig 1 acute HIV infection limits the size of viral reservoirs in lymphoid tissues, but does not impact time to virus rebound during a treatment interruption. To better understand why the reduced reservoir size did not increase the time to rebound we measured the frequency and location of HIV RNA+ cells in lymph nodes from participants in the RV254 acute infection cohort. HIV RNA+ cells were detected more frequently and in greater numbers when ART was initiated in Fiebig 1 compared to later Fiebig stages and were localized to the T-cell zone compared to the B-cell follicle with treatment in later Fiebig stages. Variability of virus production in people treated during acute infection suggests that the balance between virus-producing cells and the immune response to clear infected cells rapidly evolves during the earliest stages of infection. Clinical Trials Registration: NCT02919306.
Keyphrases
- antiretroviral therapy
- induced apoptosis
- hiv infected
- cell cycle arrest
- hiv positive
- human immunodeficiency virus
- clinical trial
- hiv aids
- hiv infected patients
- hepatitis c virus
- liver failure
- mycobacterium tuberculosis
- endoplasmic reticulum stress
- hiv testing
- randomized controlled trial
- drug induced
- respiratory failure
- cell proliferation
- south africa
- intensive care unit
- combination therapy
- smoking cessation
- study protocol
- sentinel lymph node