Combination of Tripterygium Wilfordii Hook F With Antiretroviral Therapy Delayed Viral Rebound in A Patient of Acute HIV-1 Infection

Abstract. Prolonged antiretroviral therapy (ART)-free remission post-treatment has been observed and reported in human immunodeficiency virus-1 (HIV-1) infection. The primary factors for such achievement have been linked to the transcriptional inactivation of HIV-1 DNA and immune recovery. Here, we reported a patient with acute HIV-1 infection who immediately received intensified quadruple ART. At month 9 (M9), an old CFDA-approved immuno-suppressive herbal medicine, Tripterygium Wilfordii Hook F (TwHF), was used in addition to ART. The patient was closely monitored. Virological and immunological tests as well as transcriptome analysis were carried out at each visit. The results showed that TwHF reduced serum IP-10 level and inhibited T cell activation. Both ART and TwHF were discontinued in M24, and levels of peripheral blood HIV-1 RNA and DNA remained suppressed for consecutive 12 months. With transcriptome analysis, we found pattern changes linking immuno-activation and amino acid metabolism with viral suppression and rebound. This indicates that the intentional suppression of immuno-activation is a promising approach for a functional cure of HIV-1 infection.