How often does treatment of primary HIV lead to post-treatment control?

Antivir Ther. 2015;20(8):855-63. doi: 10.3851/IMP2963. Epub 2015 Apr 23.

Abstract

Background: Post-treatment control of viraemia after discontinuation of antiretroviral therapy begun during primary HIV-1 infection is considered a potential path toward a sustained remission of infection.

Methods: Subjects enrolled in an observational primary infection cohort who received at least 11 months of highly active antiretroviral therapy beginning within the first 12 weeks of HIV-1 infection and who subsequently discontinued therapy were evaluated for post-treatment control.

Results: Within a cohort of 389 subjects with primary HIV-1 infection enrolled over 22 years, only 22 met criteria for evaluation of post-treatment control. Among these subjects, 21 (95%) had loss of viral control (HIV-1 RNA>500 copies/ml) within 18 months after treatment discontinuation, and only 1 (4.5%, 95% CI 0.32, 18.9) controlled viral load to levels <500 copies/ml for at least 24 months. The median time to virological failure was 2.17 (IQR 1.18-3.39) months.

Conclusions: Our data suggest a low likelihood of post-treatment control even when highly active antiretroviral therapy is started within 12 weeks of HIV-1 infection.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / virology*
  • HIV-1*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • RNA, Viral
  • Time Factors
  • Treatment Failure
  • Treatment Outcome
  • Viremia

Substances

  • Anti-HIV Agents
  • RNA, Viral