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Decay characteristics of HIV-1-infected compartments during combination therapy

Naturevolume 387pages188191 (1997) | Download Citation

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Abstract

Analysis of changes in viral load after initiation of treatment with potent antiretroviral agents has provided substantial insight into the dynamics of human immunodeficiency virus type 1 (HIV-1)1–3. The concentration of HIV-1 in plasma drops by 99% in the first two weeks of treatment owing to the rapid elimination of free virus with a half-life (t1/2) of ≤6 hours and loss of productively infected cells with a t1/2 of 1.6 days3. Here we show that with combination therapy this initial decrease is followed by a slower second-phase decay of plasma viraemia. Detailed mathematical analysis shows that the loss of long-lived infected cells (t1/2of1–4weeks) is a major contributor to the second phase, whereas the activation of latently infected lymphocytes (t1/2 of 0.5–2 weeks) is only a minor source. Based on these decay characteristics, we estimate that 2.3–3.1 years of a completely inhibitory treatment would be required to eliminate HIV-1 from these compartments. To eradicate HIV-1 completely, even longer treatment may be needed because of the possible existence of undetected viral compartments or sanctuary sites.

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Author notes

  1. Yunzhen Cao, Mika Vesanen, Arlene Hurley, Martin Markowitz and David D. Ho: Aaron Diamond AIDS Research Center, The Rockefeller University, 455 First Avenue, New York, New York 10016, USA

  2. Kalle Saksela: Institute of Medical Technology, University of Tampere, Tampere, Finland

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  1. Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, 87545, USA

    • Alan S. Perelson
    • , Paulina Essunger
    • , Yunzhen Cao
    • , Mika Vesanen
    • , Arlene Hurley
    • , Kalle Saksela
    • , Martin Markowitz
    •  & David D. Ho

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https://doi.org/10.1038/387188a0

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