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Post-treatment HIV control more common in patients who received early ART
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Patients with HIV who received early treatment with ART were more likely to maintain post-treatment control, according to study results published in The Journal of Infectious Diseases.
“This study represents a major collaborative effort in the field and describes the largest cohort of post-treatment HIV controllers to date,” Jonathan Z. Li, MD, assistant professor of medicine at Harvard Medical School and faculty member in the division of infectious disease at Brigham and Women’s Hospital in Boston, told Infectious Disease News.
“Post-treatment controllers are individuals who are able to achieve sustained HIV remission after discontinuation of ART,” Li said. “Post-treatment control was more commonly identified among early-treated individuals, frequently characterized by early transient viral rebound and heterogeneous durability of HIV remission.”
Li and colleagues identified 67 post-treatment controllers from 14 clinical studies — patients who maintained viral loads of 400 copies/mL or lower at more than two-thirds of time points for at least 24 weeks after interruption of ART. They compared the viral load and CD4+ dynamics of post-treatment controllers and noncontrollers.
Thirty-eight of the post-treatment controllers initiated ART during early infection with HIV, whereas 25 were treated during chronic infection. Viral suppression after ART discontinuation had a median duration of 89 weeks.
Patients treated during early infection were more frequently identified as post-treatment controllers (13%) compared with those who were treated for chronic infection (4%; P < .001). Forty-five percent of post-treatment controllers with weekly viral load monitoring had a peak post-treatment interruption viral load of 1,000 copies/mL or more, whereas 33% had a peak viral load of 10,000 copies/mL. HIV control was maintained for 2 years in 55% of post-treatment controllers and for at least 5 years in 20%.
“The identification of post-treatment HIV controllers provide hope that achieving sustained HIV remission is possible,” Li said. “Early initiation of ART has many benefits, including increasing the chances that an individual will become a post-treatment controller upon discontinuation of ART. The results of this study may help in the design of strategies and trials aimed at achieving HIV remission.” – by Bruce Thiel
Disclosure: Li reports receiving research support and consulting for Gilead Sciences and Merck. Namazi reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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