1. Continuous Prophylactic Antiretrovirals/Antiretroviral Therapy Since Birth Reduces Seeding and Persistence of the Viral Reservoir in Children Vertically Infected With Human Immunodeficiency Virus
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Usa Sukhaphan, Merlin L. Robb, Chaidan Boonrossak, Rawiwan Hansudewechakul, Tuangthip Theerawat, Naruporn Kasipong, Archawin Rojanawiwat, Supanpilat Chaisri, Danai Teewunda, Wiroi Puangtubtim, Manee Yentang, Hivnat, Thida Namwong, Thatri Iampornsin, Thitiporn Borkird, Sasithorn Burichai, Apicha Mahanontharit, Chaweewan Tonputsa, Sudarat Soongpankeeree, Watsamon Jantarabenjakul, Suvaporn Anugulruengkitt, Sasiwimol Ubolyam, Robert A. Gramzinski, Pimsiri Leowsrisook, Arena Laeyuheem, Sumet Ongwandee, Frank Maldarelli, Areerat Khongponoi, Pugpen Sirikutt, Piyarat Suntarattiwong, Worawan Faikratok, Naruemon Sassungnune, Suparat Kanjanavanit, Nelson L. Michael, Jiraporn Chucherd, Hansa Thaisri, Sarah Palmer, Lydie Trautmann, Marta Massanella, Ratchanee Saksawad, Umaporn Methanggool, Janyarak Punyim, Yosawadee Na Nakorn, Thanyawee Puthanakit, Thornthan Noppakaorattanamanee, Oratai Butterworth, Louise Leyre, Chanasda Kakkaew, Somjai Rattanamanee, Kanokkarn Wongmayurachat, Naphassanant Laopraynak, Pope Kosalarksa, Thidarat Jupimai, Juthamanee Moonwong, Tulathip Suwanlerk, Nicole Ngo-Giang-Huong, Stephen J. Kerr, Patcha Panyim, Mark de Souza, Tanawan Samleerat, Hivnat Study Groups, Wasana Prasitsuebsai, Monta Intawan, Thananda Naiwatanakul, Kulkanya Chokephaibulkit, Jintanat Ananworanich, Kesdao Nanthapisal, Suchada Chaiwut, Panadda Sawangsinth, Walairat Chaifoo, Chutima Saisaengjan, Suteeraporn Pinyakorn, Patcharaporn Pawapootarnont, Pariwat Tangpong, Patchareeyawan Srimuen, Yupawadee Jummanee, Sarawut Boonsuk, Torsak Bunupuradah, Nicolas Chomont, Preeyarach Klaytong, Julie Mitchell, Madelaine Ouellette, Cheewanan Lertpiriyasuwat, Benjamas Baipluthong, Michael Martin, Siripim Kamphaengkham, Witaya Petdachai, Rangsima Lolekha, Thita Pitimahajanaka, Gonzague Jourdain, Sunee Sirivichayakul, and Global Health
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0301 basic medicine ,Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,paediatric ,business.industry ,Art initiation ,Human immunodeficiency virus (HIV) ,virus diseases ,medicine.disease_cause ,Antiretroviral therapy ,HIV reservoir ,3. Good health ,Persistence (computer science) ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Infectious Diseases ,Cohort ,Medicine ,030212 general & internal medicine ,prophylaxis ,early antiretroviral therapy ,business ,vertical infection - Abstract
Background Early antiretroviral therapy (ART) restricts the size of the human immunodeficiency virus (HIV) reservoir in infants. However, whether antiretroviral (ARV) prophylaxis given to exposed vertically infected children exerts similar effects remains unknown. Methods We measured total and integrated HIV DNA, as well as the frequency of CD4 T cells producing multiply spliced RNA (msRNA) after stimulation (inducible reservoir) in vertically infected Thai infants. Eighty-five infants were followed longitudinally for up to 3 years. We compared the size of the reservoir in children who received continuous ARV prophylaxis since birth vs those who never received or discontinued prophylaxis before initiating ART. We used samples from a cross-sectional cohort of 37 Thai children who had initiated ART within 6 months of life to validate our findings. Results Before ART, levels of HIV DNA and the frequencies of cells producing msRNA were significantly lower in infants who received continuous ARV prophylaxis since birth compared to those in whom ARV prophylaxis was discontinued or never initiated (P < .020 and P < .001, respectively). Upon ART initiation, total and integrated HIV DNA levels decayed significantly in both groups (P Conclusions Neonatal ARV prophylaxis with direct transition to ART durably limits the size of the HIV reservoir.
- Published
- 2021
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