HIV-1 p24 may persist during long-term highly active antiretroviral therapy, increases little during short treatment breaks, and its rebound after treatment stop correlates with CD4(+) T cell loss

Publication

HIV-1 p24 may persist during long-term highly active antiretroviral therapy, increases little during short treatment breaks, and its rebound after treatment stop correlates with CD4(+) T cell loss

Journal Paper/Review - Nov 1, 2005

Schüpbach Jörg, Hirschel Bernard, Bernasconi Enos, Vernazza Pietro, Furrer Hansjakob, Battegay Manuel, Perrin Luc, Yerly Sabine, Tomasik Zuzana, Böni Jürg, Fischer Marek, Joos Beda, Günthard Huldrych, Swiss HIV Cohort Study

Units

Division of Infectious Diseases, Infection Prevention and Travel Medicine

PubMed

16249697

Citation

Schüpbach J, Hirschel B, Bernasconi E, Vernazza P, Furrer H, Battegay M, Perrin L, Yerly S, Tomasik Z, Böni J, Fischer M, Joos B, Günthard H, Swiss HIV Cohort Study. HIV-1 p24 may persist during long-term highly active antiretroviral therapy, increases little during short treatment breaks, and its rebound after treatment stop correlates with CD4(+) T cell loss. Journal of acquired immune deficiency syndromes (1999) 2005; 40:250-6.

Type

Journal Paper/Review (English)

Journal

Journal of acquired immune deficiency syndromes (1999) 2005; 40

Publication Date

Nov 1, 2005

Issn Print

1525-4135

Pages

250-6

Brief description/objective

The dynamics of HIV-1 RNA during structured treatment interruptions (STIs) are well established, but little is known about viral proteins like p24. We studied 65 participants of an STI trial. Before the trial, continuous highly active antiretroviral therapy (HAART) had suppressed their viral load to <50 copies/mL during 6 months. They then interrupted HAART during weeks 1 through 2, 11 through 12, 21 through 22, 31 through 32, and 41 through 52. The p24 was measured by boosted enzyme-linked immunosorbent assay of plasma pretreated by efficient virus disruption and heat denaturation. At time point 0, p24 was measurable in 22 patients (34%), who had maintained a viral load <50 copies/mL for 25.4 months (median, range: 6.2-38.9 months) under HAART. Viral rebounds during 2-week STIs led to a mean p24 increase of only 0.08 to 0.19 log10 (ie, 20%-60%). Pre-HAART viral load and p24 at time 0 independently predicted p24 rebounds during the 4 2-week STIs. The p24 at time 0 and HIV-1 RNA rebound during weeks 41 through 52 independently determined the concomitant p24 rebound. An increase of p24 but not viral load during the first 8 weeks of the long STI correlated significantly with concomitant CD4(+) T cell loss. Persisting p24 despite successful HAART may reflect virus replication in reservoirs not represented by plasma viral load and has implications for the concept of therapeutic vaccination.