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The CARMA study: early infant antiretroviral therapy-timing impacts on total HIV-1 DNA quantitation 12 Years later
journal contribution
posted on 2023-06-09, 21:45 authored by Caroline Foster, Sara Domínguez-Rodríguez, Alfredo Tagarro, Triantafylia Gkouleli, Judith Heaney, Sarah Watters, Alasdair Bamford, Katy FidlerKaty Fidler, Marisa Navarro, Anita De Rossi, Paolo Palma, Eleni Nastouli, Paolo Rossi, Carlo Giaquinto, Pablo Rojo, (EPIICAL) ConsortiumBackground Strategies aimed at antiretroviral therapy (ART)–free remission will target individuals with a limited viral reservoir. We investigated factors associated with low reservoir measured as total human immunodeficiency virus type 1 (HIV-1) DNA in peripheral blood mononuclear cells (PBMCs) in perinatal infection (PaHIV). Methods Children from 7 European centers in the Early Treated Perinatally HIV Infected Individuals: Improving Children’s Actual Life (EPIICAL) consortium who commenced ART aged <2 years, and remained suppressed (viral load [VL] <50 copies/mL) for >5 years were included. Total HIV-1 DNA was measured by quantitative polymerase chain reaction per million PBMCs. Factors associated with total HIV-1 DNA were analyzed using generalized additive models. Age, VL at ART initiation, and baseline CD4% effects were tested including smoothing splines to test nonlinear association. Results Forty PaHIV, 27 (67.5%) female 21 (52.5%) Black/Black African, had total HIV-1 DNA measured; median 12 (IQR, 7.3–15.4) years after ART initiation. Eleven had total HIV-1 DNA <10 copies/106 PBMCs. HIV-1 DNA levels were positively associated with age and VL at ART initiation, baseline CD4%, and Western blot antibody score. Age at ART initiation presented a linear association (coefficient = 0.10 ± 0.001, P = .001), the effect of VL (coefficient = 0.35 ± 0.1, P = .001) noticeable >6 logs. The effect of CD4% (coefficient = 0.03 ± 0.01, P = .049) was not maintained >40%. Conclusions In this PaHIV cohort, reduced total HIV-1 DNA levels were associated with younger age and lower VL at ART initiation. The impact of early-infant treatment on reservoir size persists after a decade of suppressive therapy.
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Publication status
- Published
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- Published version
Journal
Journal of the Pediatric Infectious Diseases SocietyISSN
2048-7193Publisher
Oxford University Press (OUP)External DOI
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1-7Event location
EnglandDepartment affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2020-10-05First Open Access (FOA) Date
2020-10-05First Compliant Deposit (FCD) Date
2020-10-05Usage metrics
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