Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies

Jesper D. Gunst (), Jesal Gohil, Johanthan Z. Li, Ronald J. Bosch, Catherine Seamon Andrea White, Tae-Wook Chun, Beatriz Mothe, Kathleen Gittens, Lauren Praiss, Marie-Angélique Scheerder, Linos Vandekerckhove, Kevin Escandón, Ann Thorkelson, Timothy Schacker, Devi SenGupta, Christian Brander, Emmanouil Papasavvas, Luis J. Montaner, Javier Martinez-Picado, Ruxandra Calin, Antonella Castagna, Camilla Muccini, Wesley de Jong, Lorna Leal, Felipe Garcia, Rob A. Gruters, Timothy Tipoe, John Frater, Ole S. Søgaard and Sarah Fidler
Additional contact information
Jesper D. Gunst: Aarhus University Hospital
Jesal Gohil: Imperial College NIHR BRC
Johanthan Z. Li: Harvard Medical School
Ronald J. Bosch: Harvard T.H. Chan School of Public Health
Catherine Seamon Andrea White: National Institutes of Health
Tae-Wook Chun: National Institutes of Health
Beatriz Mothe: IrsiCaixa Immunopathology Research Institute
Kathleen Gittens: National Institutes of Health
Lauren Praiss: National Institutes of Health
Marie-Angélique Scheerder: Ghent University Hospital
Linos Vandekerckhove: Ghent University
Kevin Escandón: University of Minnesota
Ann Thorkelson: University of Minnesota
Timothy Schacker: University of Minnesota
Devi SenGupta: Inc
Christian Brander: IrsiCaixa Immunopathology Research Institute
Emmanouil Papasavvas: The Wistar Institute
Luis J. Montaner: The Wistar Institute
Javier Martinez-Picado: IrsiCaixa Immunopathology Research Institute
Ruxandra Calin: Tenon Hospital, Sorbonne University, AP-HP
Antonella Castagna: Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute
Camilla Muccini: Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute
Wesley de Jong: Erasmus MC
Lorna Leal: Hospital Clínic Barcelona
Felipe Garcia: Hospital Clínic Barcelona
Rob A. Gruters: Erasmus MC
Timothy Tipoe: University of Oxford, UK and NIHR Oxford Biomedical Research Centre
John Frater: University of Oxford, UK and NIHR Oxford Biomedical Research Centre
Ole S. Søgaard: Aarhus University Hospital
Sarah Fidler: Imperial College NIHR BRC

Nature Communications, 2025, vol. 16, issue 1, 1-13

Abstract: Abstract The only current strategy to test efficacy of novel interventions for sustained HIV control without antiretroviral therapy (ART) among people with HIV (PWH) is through an analytical treatment interruption (ATI). Inclusion of ‘placebo’ controls in ATIs poses ethical, logistical, and economic challenges. To understand viral dynamics and rates of post-treatment control (PTC) after ATI among PWH receiving either placebo or no intervention, we undertook an individual-participant data meta-analysis. In total, 24 eligible prospective studies with 382 individuals with ≥5 plasma HIV RNA viral loads (pVLs) within the first 84 days post-ATI were included. Early-ART was defined as ART initiation within 6 months of HIV acquisition; others were classified as late-ART or unknown. Median age was 42 years, 91% male, 75% white, 45% received early-ART. Median time to pVL >50, >400, and >10,000 copies/mL was 16 days (interquartile range [IQR]:13–25), 21 (IQR:15–28), and 32 (IQR:20–35), respectively. PTC defined as pVL

Date: 2025
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DOI: 10.1038/s41467-025-56116-1

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