Rapid HIV RNA rebound after antiretroviral treatment interruption in persons durably suppressed in Fiebig I acute HIV infection

Abstract

Antiretroviral therapy during the earliest stage of acute HIV infection (Fiebig I) might minimize establishment of a latent HIV reservoir and thereby facilitate viremic control after analytical treatment interruption. We show that 8 participants, who initiated treatment during Fiebig I and were treated for a median of 2.8 years, all experienced rapid viral load rebound following analytical treatment interruption, indicating that additional strategies are required to control or eradicate HIV.

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Fig. 1: Viral load rebound following ATI in eight Fiebig I acutely treated participants.
Fig. 2: Longitudinal HIV reservoir markers and immune responses.

Change history

  • 05 September 2018

    In the version of this article originally published, the accession codes in the Data Availability section of the Methods were not linked correctly. The original URLs were https://www.ncbi.nlm.nih.gov/genbank/mf957336/ for MF957336 and https://www.ncbi.nlm.nih.gov/genbank/mf957707/ for MF957707; they should have been https://www.ncbi.nlm.nih.gov/nuccore/MF957336 and https://www.ncbi.nlm.nih.gov/nuccore/MF957707, respectively. The error has been corrected.

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Acknowledgements

We are grateful to the participants who have made this research possible. We thank T. Schacker for providing data on the lymph nodes from one participant. This work was supported by the NIH grant R01AI108433, a cooperative agreement (W81XWH-07-2- 0067) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. and the U.S. Department of Defense (DoD), the Division of AIDS at the U.S. National Institute of Allergy and Infectious Diseases, and by an intramural grant from the Thai Red Cross AIDS Research Centre. The US Army Medical Research Acquisition Activity (820 Chandler Street, Fort Detrick, MD 21702-5014, USA) is the awarding and administering acquisition office for the cooperative agreement. It is also supported in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. Antiretroviral therapy was supported by the Thai Government Pharmaceutical Organization, Gilead, Merck and ViiV Healthcare. The views expressed are those of the authors. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, the US Army, or the Department of Defense, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government, including the US National Institutes of Health.

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D.J.C., E.K., L.F., T.A.C., R.O.C., J.H.K., N.L.M., M.L.R., N.P., and J.A. designed the study. S.P. designed and performed the statistical analyses. L.T., L.L., A.P., M.R., H.T., S.B., R.M., E.K.H., S.T., S.U., D.L.B., B.A.F., R.J.G., R.T., and N. Chomont designed and performed the laboratory experiments. D.J.C. and J.A. led the study, with support from E.K., J.I. and N. Chomchey in managing the study. J.A. drafted the manuscript. All authors reviewed the manuscript, provided feedback, and approved the manuscript in its final form.

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Correspondence to Jintanat Ananworanich.

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Competing interests

T.A.C. has received a speaker’s fee from Gilead. J.A. has received honorarium for participating in advisory meetings from Merck, Roche, AbbVie, Gilead, and ViiV Healthcare. P.D. is an employee of EMMES corporation. All other authors declare no competing financial interests.

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Colby, D.J., Trautmann, L., Pinyakorn, S. et al. Rapid HIV RNA rebound after antiretroviral treatment interruption in persons durably suppressed in Fiebig I acute HIV infection. Nat Med 24, 923–926 (2018). https://doi.org/10.1038/s41591-018-0026-6

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