TY - JOUR
T1 - Cell-associated HIV-1 RNA predicts viral rebound and disease progression after discontinuation of temporary early ART
AU - Pasternak, Alexander O.
AU - Grijsen, Marlous L.
AU - Wit, Ferdinand W.
AU - Bakker, Margreet
AU - Jurriaans, Suzanne
AU - Prins, Jan M.
AU - Berkhout, Ben
PY - 2020/3/26
Y1 - 2020/3/26
N2 - Plasma viral load (VL) and CD4+ T cell count are widely used as biomarkers of HIV type 1 (HIV-1) replication, pathogenesis, and response to antiretroviral therapy (ART). However, the clinical potential of cell-associated (CA) HIV-1 molecular markers is much less understood. Here, we measured CA HIV-1 RNA and DNA in HIV-infected individuals treated with temporary ART initiated during primary HIV-1 infection. We demonstrate substantial predictive value of CA RNA for (a) the virological and immunological response to early ART, (b) the magnitude and time to viral rebound after discontinuation of early ART, and (c) disease progression in the absence of treatment. Remarkably, when adjusted for CA RNA, plasma VL no longer appeared as an independent predictor of any clinical endpoint in this cohort. The potential of CA RNA as an HIV-1 clinical marker, in particular as a predictive biomarker of virological control after stopping ART, should be explored in the context of HIV-1 curative interventions.
AB - Plasma viral load (VL) and CD4+ T cell count are widely used as biomarkers of HIV type 1 (HIV-1) replication, pathogenesis, and response to antiretroviral therapy (ART). However, the clinical potential of cell-associated (CA) HIV-1 molecular markers is much less understood. Here, we measured CA HIV-1 RNA and DNA in HIV-infected individuals treated with temporary ART initiated during primary HIV-1 infection. We demonstrate substantial predictive value of CA RNA for (a) the virological and immunological response to early ART, (b) the magnitude and time to viral rebound after discontinuation of early ART, and (c) disease progression in the absence of treatment. Remarkably, when adjusted for CA RNA, plasma VL no longer appeared as an independent predictor of any clinical endpoint in this cohort. The potential of CA RNA as an HIV-1 clinical marker, in particular as a predictive biomarker of virological control after stopping ART, should be explored in the context of HIV-1 curative interventions.
UR - http://www.scopus.com/inward/record.url?scp=85082835890&partnerID=8YFLogxK
U2 - https://doi.org/10.1172/jci.insight.134196
DO - https://doi.org/10.1172/jci.insight.134196
M3 - Article
C2 - 32097124
SN - 2379-3708
VL - 5
JO - JCI Insight
JF - JCI Insight
IS - 6
M1 - e134196
ER -