Paradoxically Greater Persistence of HIV RNA-Positive Cells in Lymphoid Tissue When ART Is Initiated in the Earliest Stage of Infection. (11th March 2022)

• Record Type: Journal Article
• Authors: Kroon, Eugène; Chottanapund, Suthat; Buranapraditkun, Supranee; Sacdalan, Carlo; Colby, Donn J; Chomchey, Nitiya; Prueksakaew, Peeriya; Pinyakorn, Suteeraporn; Trichavaroj, Rapee; Vasan, Sandhya; Manasnayakorn, Sopark; Reilly, Cavan; Helgeson, Erika; Anderson, Jodi; David, Caitlin; Zulk, Jacob; de Souza, Mark; Tovanabutra, Sodsai; Schuetz, Alexandra; Robb, Merlin L; Douek, Daniel C; Phanuphak, Nittaya; Haase, Ashley; Ananworanich, Jintanat; Schacker, Timothy W
• Is Part Of: Journal of infectious diseases. Volume 225:Number 12(2022)
• Page Start: 2167
• Page End: 2175
• Publication Date: 2022-03-11
• Subjects: acute HIV infection -- antiretroviral therapy -- in situ hybridization -- HIV reservoir -- lymphoid tissues; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiac089
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Starting antiretroviral therapy (ART) in Fiebig 1 acute HIV infection limits the size of viral reservoirs in lymphoid tissues, but does not impact time to virus rebound during a treatment interruption. To better understand why the reduced reservoir size did not increase the time to rebound we measured the frequency and location of HIV RNA + cells in lymph nodes from participants in the RV254 acute infection cohort. HIV RNA + cells were detected more frequently and in greater numbers when ART was initiated in Fiebig 1 compared to later Fiebig stages and were localized to the T-cell zone compared to the B-cell follicle with treatment in later Fiebig stages. Variability of virus production in people treated during acute infection suggests that the balance between virus-producing cells and the immune response to clear infected cells rapidly evolves during the earliest stages of infection. Clinical Trials Registration : NCT02919306. Abstract : People treated in the very earliest stages of acute HIV infection have significantly higher frequencies of viral RNA-positive cells detected in lymphoid tissue after a year of ART compared to treatment in later stages.