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

Janine Maenza, Kenneth Tapia, Sarah Holte, Joanne D Stekler, Claire E Stevens, James I Mullins, Ann C Collier

Corresponding author name: Janine Maenza
Corresponding author e-mail: janine@u.washington.edu

Citation: Antiviral Therapy 2015; 20:855-863
doi: 10.3851/IMP2963

Date accepted: 10 April 2015
Date published online: 23 April 2015

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.

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