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Early ART led to smaller HIV reservoir
Patients who receive antiretroviral therapy less than 6 months after becoming infected with HIV have a smaller HIV reservoir while receiving long-term therapy, researchers from the University of California, San Francisco, have found.
“Cellular reservoirs of latent genomically integrated HIV are established quickly after infection, but studies investigating whether ART initiated in the first few months following infection can limit the size of the established reservoir have reached inconsistent conclusions,” the researchers wrote in the Journal of Infectious Diseases. “The growing research effort aimed at eradicating HIV infection will depend on more precisely elucidating the role early ART may play in limiting the growth of the viral reservoir.”
The study included patients from the Options Project, a prospective cohort of individuals who enrolled less than 12 months after HIV seroconversion (less than 6 months since 2003). Patients fell into four categories: those who initiated ART less than 6 months after HIV infection; patients who initiated ART at least 2 years after estimated infection date; people who were untreated for a year or more after HIV diagnosis and HIV-negative controls.
The mean T-cell CD4+ activation level was 5.2% among those in the early ART group and 7.5% in the later ART group. In the early ART group, mean CD8+ T-cell activation level was 22.1%. In the later ART group, the mean CD8+ T-cell activation level was 28.8% (P=.009). Although the CD8+ T-cell activation level was lower for early ART compared with later ART, it was still higher compared with HIV-negative controls. The researchers also found that patients in the early ART group had lower HIV RNA and DNA levels compared with the later ART group.
“Our study argues for more pathophysiologic research to confirm the biologic pathways mediating the positive impact of early-initiated ART,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.