Age at antiretroviral therapy initiation and cell-associated HIV-1 DNA levels in HIV-1-infected children

Louise Kuhn, Maria Paximadis, Bianca Da Costa Dias, Shayne Loubser, Renate Strehlau, Faeezah Patel, Stephanie Shiau, Ashraf Coovadia, Elaine J Abrams and Caroline T Tiemessen

PLOS ONE, 2018, vol. 13, issue 4, 1-14

Abstract: Background: The latent viral reservoir is the major obstacle to achieving HIV remission and necessitates life-long antiretroviral therapy (ART) for HIV-infected individuals. Studies in adults and children have found that initiating ART soon after infection is associated with a reduction in the size of the HIV-1 reservoir. Here we quantified cell-associated HIV-1 DNA in early-treated but currently older HIV-infected children suppressed on ART. Methods: The study participants comprised of a cohort of 146 early-treated children with HIV-1 RNA 50 copies/ml whilst on ART within 3 years after the DNA measurement was 2.07 (95% CI: 1.352–3.167) times greater if the HIV-1 DNA level was above the median of 55 copies/106 cells. Conclusions: Cell-associated HIV-1 DNA levels measured after more than 4 years on ART were lower the younger the age of the child when ART was initiated. This marker of the size of the viral reservoir also predicted subsequent viral rebound/treatment failure while ART was sustained. The results provide additional evidence of the benefits of prompt diagnosis and early ART initiation in newborns and infants.

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0195514

DOI: 10.1371/journal.pone.0195514

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