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Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission

Abstract : BACKGROUND: Therapeutic control of HIV replication reduces the size of the viral reservoir, particularly among central memory CD4+ T cells, and this effect might be accentuated by early treatment. METHODS: We examined the effect of ART initiated at the time of the primary HIV infection (early ART), lasting 2 and 6 years in 11 and 10 patients, respectively, on the HIV reservoir in peripheral resting CD4+ T cells, sorted into naive (TN), central memory (TCM), transitional memory (TTM) and effector memory (TEM) cells, by comparison with 11 post-treatment controllers (PTCs). RESULTS: Between baseline and 2 years, CD4+ T cell subset numbers increased markedly (P \textless 0.004) and HIV DNA levels decreased in all subsets (P \textless 0.009). TTM cells represented the majority of reservoir cells at both timepoints, T cell activation status normalized and viral diversity remained stable over time. The HIV reservoir was smaller after 6 years of early ART than after 2 years (P \textless 0.019), and did not differ between PTCs and patients treated for 6 years. One patient, who had low reservoir levels in all T cell subsets after 2 years of treatment similar to the levels in PTCs, spontaneously controlled viral replication during 18 months off treatment. CONCLUSIONS: Early prolonged ART thus limits the size of the HIV reservoir, protects long-lived cells from persistent infection and may enhance post-treatment control.
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https://hal-pasteur.archives-ouvertes.fr/pasteur-01420415
Contributor : Marie-Genevieve Guibert <>
Submitted on : Tuesday, December 20, 2016 - 3:28:28 PM
Last modification on : Wednesday, September 16, 2020 - 5:11:59 PM

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Antoine Cheret, Charline Bacchus-Souffan, Véronique Avettand-Fenoël, Adeline Mélard, Georges Nembot, et al.. Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2015, 70 (7), pp.2108--2120. ⟨10.1093/jac/dkv084⟩. ⟨pasteur-01420415⟩

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