Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission.
J Antimicrob Chemother
; 70(7): 2108-20, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25900157
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 (Pâ<â0.004) and HIV DNA levels decreased in all subsets (Pâ<â0.009). 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 (Pâ<â0.019), 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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Linfócitos T CD4-Positivos
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Infecções por HIV
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Terapia Antirretroviral de Alta Atividade
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Antirretrovirais
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Prevenção Secundária
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article