Background. Strategies aimed at antiretroviral therapy (ART)-free remission will target individuals with a limited viral reservoir. We investigated factors associated with low reservoir measured as total human immunodeficiency virus type 1 (HIV-1) DNA in peripheral blood mononuclear cells (PBMCs) in perinatal infection (PaHIV).Methods. Children from 7 European centers in the Early Treated Perinatally HIV Infected Individuals: Improving Children's Actual Life (EPIICAL) consortium who commenced ART aged <2 years, and remained suppressed (viral load [VL] <50 copies/mL) for >5 years were included. Total HIV-1 DNA was measured by quantitative polymerase chain reaction per million PBMCs. Factors associated with total HIV-1 DNA were analyzed using generalized additive models. Age, VL at ART initiation, and baseline CD4% effects were tested including smoothing splines to test nonlinear association.Results. Forty PaHIV, 27 (67.5%) female 21 (52.5%) Black/Black African, had total HIV-1 DNA measured; median 12 (IQR, 7.3-15.4) years after ART initiation. Eleven had total HIV-1 DNA <10 copies/10(6) PBMCs. HIV-1 DNA levels were positively associated with age and VL at ART initiation, baseline CD4%, and Western blot antibody score. Age at ART initiation presented a linear association (coefficient = 0.10 +/- 0.001, P <= .001), the effect of VL (coefficient = 0.35 +/- 0.1, P <= .001) noticeable >6 logs. The effect of CD4% (coefficient = 0.03 +/- 0.01, P <= .049) was not maintained >40%.Conclusions. In this PaHIV cohort, reduced total HIV-1 DNA levels were associated with younger age and lower VL at ART initiation. The impact of early-infant treatment on reservoir size persists after a decade of suppressive therapy.

Foster, C., Dominguez-Rodriguez, S., Tagarro, A., Gkouleli, T., Heaney, J., Watters, S., et al. (2021). The CARMA Study: Early Infant Antiretroviral Therapy - Timing Impacts on Total HIV-1 DNA Quantitation 12 Years Later. JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 10(3), 295-301 [10.1093/jpids/piaa071].

The CARMA Study: Early Infant Antiretroviral Therapy - Timing Impacts on Total HIV-1 DNA Quantitation 12 Years Later

Palma P.;Rossi P.;
2021-01-01

Abstract

Background. Strategies aimed at antiretroviral therapy (ART)-free remission will target individuals with a limited viral reservoir. We investigated factors associated with low reservoir measured as total human immunodeficiency virus type 1 (HIV-1) DNA in peripheral blood mononuclear cells (PBMCs) in perinatal infection (PaHIV).Methods. Children from 7 European centers in the Early Treated Perinatally HIV Infected Individuals: Improving Children's Actual Life (EPIICAL) consortium who commenced ART aged <2 years, and remained suppressed (viral load [VL] <50 copies/mL) for >5 years were included. Total HIV-1 DNA was measured by quantitative polymerase chain reaction per million PBMCs. Factors associated with total HIV-1 DNA were analyzed using generalized additive models. Age, VL at ART initiation, and baseline CD4% effects were tested including smoothing splines to test nonlinear association.Results. Forty PaHIV, 27 (67.5%) female 21 (52.5%) Black/Black African, had total HIV-1 DNA measured; median 12 (IQR, 7.3-15.4) years after ART initiation. Eleven had total HIV-1 DNA <10 copies/10(6) PBMCs. HIV-1 DNA levels were positively associated with age and VL at ART initiation, baseline CD4%, and Western blot antibody score. Age at ART initiation presented a linear association (coefficient = 0.10 +/- 0.001, P <= .001), the effect of VL (coefficient = 0.35 +/- 0.1, P <= .001) noticeable >6 logs. The effect of CD4% (coefficient = 0.03 +/- 0.01, P <= .049) was not maintained >40%.Conclusions. In this PaHIV cohort, reduced total HIV-1 DNA levels were associated with younger age and lower VL at ART initiation. The impact of early-infant treatment on reservoir size persists after a decade of suppressive therapy.
2021
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA
English
HIV reservoir
HIV-1
adolescents
children
early treated
viral suppression
Foster, C., Dominguez-Rodriguez, S., Tagarro, A., Gkouleli, T., Heaney, J., Watters, S., et al. (2021). The CARMA Study: Early Infant Antiretroviral Therapy - Timing Impacts on Total HIV-1 DNA Quantitation 12 Years Later. JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 10(3), 295-301 [10.1093/jpids/piaa071].
Foster, C; Dominguez-Rodriguez, S; Tagarro, A; Gkouleli, T; Heaney, J; Watters, S; Bamford, A; Fidler, K; Navarro, M; De Rossi, A; Palma, P; Nastouli,...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/277513
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