期刊
JOURNAL OF CLINICAL VIROLOGY
卷 53, 期 1, 页码 29-32出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jcv.2011.09.018
关键词
HIV-1; Reservoir; nadir CD4 T cells; Antiretroviral therapy
类别
资金
- American Foundation for AIDS Research (amfAR) [106722-40RGRL]
- Canadian Foundation for AIDS Research (CANFAR) [017-718]
- Canadian HIV Trials Network-Canadian Institutes of Health Research (CTN-CIHR) [CTN 205]
- Fonds de la recherche en sante du Quebec (FRSQ)
- Sida et maladies infectieuses
- Canadian Institutes of Health Research (CIHR) [HOP-103230]
Background: The level of HIV-1 integrated DNA in CD4 T cells was reported to predict the evolution of untreated HIV-1 infection independently of CD4 cell counts or plasma HIV-1 RNA levels. However, the relevance of reservoir level while on efficient antiretroviral therapy (ART) is still unknown. Objectives: To evaluate factors that may contribute to the establishment and maintenance of HIV-1 reservoir size in ART-treated HIV-1-infected adults with complete suppression of viremia. Study design: 35 subjects receiving ART with plasma HIV-1 RNA below the limit of detection for an average duration of 3.2 years were studied. A highly sensitive PCR was used to assess HIV-1 integrated DNA levels in sorted CD4 T cells. Results: The mean HIV-1 integrated DNA was 300 +/- 7 copies/10(6) CD4 cells (range 10-1408). In univariate analysis, the levels of HIV-1 proviral DNA appeared to be independent of duration of HIV-1-infection, duration on ART, time since HIV-1 viral load was undetectable, delay between HIV-1 infection and starting ART, or viral load before starting ART. Conversely, CD4 T cell nadir, CD4/CD8 ratio and, to lesser degree, CD4 T cell counts were inversely associated with HIV-1 proviral DNA levels. In multivariate analysis, only CD4 T cell nadir significantly predicted levels of HIV-1 proviral DNA (P = 0.025). Conclusions: CD4 T cell nadir strongly predicted reservoir size independently of other factors in HIV-1-infected adults with complete suppression of viremia. Collectively, these results indicate that the extent of CD4 T cell depletion before ART drives the size of the viral reservoir after prolonged therapy. (C) 2011 Elsevier B. V. All rights reserved.
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