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Impact of treatment with raltegravir during primary or chronic HIV infection on RNA decay characteristics and the HIV viral reservoir.
- Source :
-
AIDS (London, England) [AIDS] 2011 Nov 13; Vol. 25 (17), pp. 2069-78. - Publication Year :
- 2011
-
Abstract
- Background: Eradication of HIV-1 is prevented by the formation of viral reservoirs in peripheral blood, lymphoid tissues and other sanctuary sites. In most patients, rebound upon treatment cessation is prompt. We assessed whether early treatment with raltegravir can impact on the formation of the viral reservoir.<br />Methods: We conducted an open-label, nonrandomized study, and assessed in detail the decay characteristics of HIV-1 RNA in plasma, HIV DNA in CD4 T cells and colon tissue biopies (CTBs) in 16 treatment-naive patients during either primary (PHI, n = 8) or chronic (CHI, n = 8) HIV-1 infection after treatment with raltegravir and Truvada for 52 weeks.<br />Results: HIV-1 RNA decreased rapidly with treatment in all patients; first and second phase levels were lower in PHI patients with no appreciable difference in residual viremia between the two groups at 52 weeks. Episomal HIV-1 DNA increased sharply in both groups with peak levels at 3-4 weeks. Total HIV-1 DNA levels were reduced in both groups with similar kinetics, but were markedly lower in PHI patients after 52 weeks. Integrated HIV-1 DNA levels were significantly lower at baseline in PHI patients and this difference widened on treatment. Finally, total HIV-1 DNA decayed substantially in both groups in CTB.<br />Conclusion: Treatment with raltegravir resulted in a large number of abrogated integration events, reflected by the increase of episomal HIV-1 DNA after treatment initiation. Levels of total and integrated HIV-1 DNA were lower in PHI patients at the end of the study period.
- Subjects :
- Adult
Australia epidemiology
CD4 Lymphocyte Count
Colon drug effects
Colon immunology
Colon pathology
HIV Infections immunology
HIV Infections pathology
HIV Infections virology
HIV-1 genetics
Humans
Male
Middle Aged
Pilot Projects
RNA, Viral analysis
RNA, Viral drug effects
Raltegravir Potassium
Sequence Analysis, RNA
Viral Load drug effects
Virus Latency immunology
Virus Replication immunology
Anti-HIV Agents pharmacology
Colon virology
HIV Infections drug therapy
HIV-1 drug effects
Pyrrolidinones pharmacology
Virus Latency drug effects
Virus Replication drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5571
- Volume :
- 25
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- AIDS (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 21860347
- Full Text :
- https://doi.org/10.1097/QAD.0b013e32834b9658