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Antiretroviral Initiation at >= 800 CD4+Cells/mm(3) Associated With Lower Human Immunodeficiency Virus Reservoir Size

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dc.contributor.author Rasmussen, TA
dc.contributor.author Ahuja, SK
dc.contributor.author Kuwanda, L
dc.contributor.author Vjecha, MJ
dc.contributor.author Hudson, F
dc.contributor.author Lal, L
dc.contributor.author Rhodes, A
dc.contributor.author Chang, J
dc.contributor.author Palmer, S
dc.contributor.author Auberson-Munderi, P
dc.contributor.author Mugerwa, H
dc.contributor.author Wood, R
dc.contributor.author Badal-Faesen, S
dc.contributor.author Pillay, S
dc.contributor.author Mngqibisa, R
dc.contributor.author LaRosa, A
dc.contributor.author Hildago, J
dc.contributor.author Petoumenos, K
dc.contributor.author Chiu, C
dc.contributor.author Lutaakome, J
dc.contributor.author Kitonsa, J
dc.contributor.author Kabaswaga, E
dc.contributor.author Pala, P
dc.contributor.author Ganoza, Carmela
dc.contributor.author Fisher, K
dc.contributor.author Chang, C
dc.contributor.author Lewin, SR
dc.contributor.author Wright, EJ
dc.date.accessioned 2022-06-25T20:36:43Z
dc.date.available 2022-06-25T20:36:43Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/11892
dc.description.abstract Background: Identifying factors that determine the frequency of latently infected CD4+ T cells on antiretroviral therapy (ART) may inform strategies for human immunodeficiency virus (HIV) cure. We investigated the role of CD4+ count at ART initiation for HIV persistence on ART. Methods: Among participants of the Strategic Timing of Antiretroviral Treatment Study, we enrolled people with HIV (PWH) who initiated ART with CD4+ T-cell counts of 500–599, 600–799, or ≥ 800 cells/mm3. After 36–44 months on ART, the levels of total HIV-DNA, cell-associated unspliced HIV-RNA (CA-US HIV-RNA), and two-long terminal repeat HIV-DNA in CD4+ T cells were quantified and plasma HIV-RNA was measured by single-copy assay. We measured T-cell expression of Human Leucocyte Antigen-DR Isotype (HLA-DR), programmed death-1, and phosphorylated signal transducer and activator of transcription-5 (pSTAT5). Virological and immunological measures were compared across CD4+ strata. Results: We enrolled 146 PWH, 36 in the 500–599, 60 in the 600–799, and 50 in the ≥ 800 CD4 strata. After 36–44 months of ART, total HIV-DNA, plasma HIV-RNA, and HLA-DR expression were significantly lower in PWH with CD4+ T-cell count ≥ 800 cells/mm3 at ART initiation compared with 600–799 or 500–599 cells/mm3. The median level of HIV-DNA after 36–44 months of ART was lower by 75% in participants initiating ART with ≥ 800 vs 500–599 cells/mm3 (median [interquartile range]: 16.3 [7.0–117.6] vs 68.4 [13.7–213.1] copies/million cells, respectively). Higher pSTAT5 expression significantly correlated with lower levels of HIV-DNA and CA-US HIV-RNA. Virological measures were significantly lower in females. Conclusions: Initiating ART with a CD4+ count ≥ 800 cells/mm3 compared with 600–799 or 500–599 cells/mm3 was associated with achieving a substantially smaller HIV reservoir on ART. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Clinical Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HIV en_US
dc.subject HIV reservoir en_US
dc.subject antiretroviral therapy en_US
dc.subject HIV cure en_US
dc.title Antiretroviral Initiation at >= 800 CD4+Cells/mm(3) Associated With Lower Human Immunodeficiency Virus Reservoir Size en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/cid/ciac249
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1537-6591


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