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HIV-1 latent reservoir size and diversity are stable following brief treatment interruption
D. Brenda Salantes, … , Pablo Tebas, Katharine J. Bar
D. Brenda Salantes, … , Pablo Tebas, Katharine J. Bar
Published July 2, 2018; First published June 18, 2018
Citation Information: J Clin Invest. 2018;128(7):3102-3115. https://doi.org/10.1172/JCI120194.
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Categories: Clinical Medicine AIDS/HIV Clinical trials

HIV-1 latent reservoir size and diversity are stable following brief treatment interruption

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Abstract

BACKGROUND. The effect of a brief analytical treatment interruption (ATI) on the HIV-1 latent reservoir of individuals who initiate antiretroviral therapy (ART) during chronic infection is unknown. METHODS. We evaluated the impact of transient viremia on the latent reservoir in participants who underwent an ATI and at least 6 months of subsequent viral suppression in a clinical trial testing the effect of passive infusion of the broadly neutralizing Ab VRC01 during ATI. RESULTS. Measures of total HIV-1 DNA, cell-associated RNA, and infectious units per million cells (IUPM) (measured by quantitative viral outgrowth assay [QVOA]) were not statistically different before or after ATI. Phylogenetic analyses of HIV-1 env sequences from QVOA and proviral DNA demonstrated little change in the composition of the virus populations comprising the pre- and post-ATI reservoir. Expanded clones were common in both QVOA and proviral DNA sequences. The frequency of clonal populations differed significantly between QVOA viruses, proviral DNA sequences, and the viruses that reactivated in vivo. CONCLUSIONS. The results indicate that transient viremia from ATI does not substantially alter measures of the latent reservoir, that clonal expansion is prevalent within the latent reservoir, and that characterization of latent viruses that can reactivate in vivo remains challenging. TRIAL REGISTRATION. ClinicalTrials.gov NCT02463227 FUNDING. Funding was provided by the NIH.

Authors

D. Brenda Salantes, Yu Zheng, Felicity Mampe, Tuhina Srivastava, Subul Beg, Jun Lai, Jonathan Z. Li, Randall L. Tressler, Richard A. Koup, James Hoxie, Mohamed Abdel-Mohsen, Scott Sherrill-Mix, Kevin McCormick, E. Turner Overton, Frederic D. Bushman, Gerald H. Learn, Robert F. Siliciano, Janet M. Siliciano, Pablo Tebas, Katharine J. Bar

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Figure 1

Study schema.

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Study schema.
The A5340 clinical trial schema is shown at the top, with ...
The A5340 clinical trial schema is shown at the top, with the type and timing of clinical specimens obtained for the present study shown in the center, and the assays performed shown at the bottom.
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