Imperial College London
Alternate

Emeritus ProfessorMyraMcClure

Faculty of Medicine, Department of Infectious Disease

Emeritus Professor of Retrovirology
 
 
 
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Contact

 

+44 (0)20 7594 3902m.mcclure

 
 
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Location

 

456Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Gossez:2019:10.1097/QAD.0000000000002044,
author = {Gossez, M and Martin, GE and Pace, M and Ramjee, G and Premraj, A and Kaleebu, P and Rees, H and Inshaw, J and Stöhr, W and Meyerowitz, J and Hopkins, E and Jones, M and Hurst, J and Porter, K and Babiker, A and Fidler, S and Frater, J and SPARTAC, Trial Investigators},
doi = {10.1097/QAD.0000000000002044},
journal = {AIDS},
pages = {185--197},
title = {Virological remission after antiretroviral therapy interruption in female African HIV seroconverters},
url = {http://dx.doi.org/10.1097/QAD.0000000000002044},
volume = {33},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - INTRODUCTION: There are few data on the frequency of virological remission in African individuals after treatment with antiretroviral therapy (ART) in primary HIV infection (PHI). METHODS: We studied participants (n=82) from South Africa and Uganda in Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion, the first trial of treatment interruption in African individuals with PHI randomized to deferred ART or 48 weeks of immediate ART. All were female and infected with non-B HIV subtypes, mainly C. We measured HIV DNA in CD4 T cells, CD4 cell count, plasma viral load (pVL), cell-associated HIV RNA and T-cell activation and exhaustion. We explored associations with clinical progression and time to pVL rebound after treatment interruption (n=22). Data were compared with non-African Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion participants. RESULTS: Pretherapy pVL and integrated HIV DNA were lower in Africans compared with non-Africans (median 4.16 vs. 4.72 log10copies/ml and 3.07 vs. 3.61 log10copies/million CD4 T cells, respectively; P<0.001). Pre-ART HIV DNA in Africans was associated with clinical progression (P=0.001, HR per log10copies/million CD4 T cells increase (95% CI) 5.38 (1.95-14.79)) and time to pVL rebound (P=0.034, HR per log10copies/ml increase 4.33 (1.12-16.84)). After treatment interruption, Africans experienced longer duration of viral remission than non-Africans (P<0.001; HR 3.90 (1.75-8.71). Five of 22 African participants (22.7%) maintained VL less than 400copies/ml over a median of 188 weeks following treatment interruption. CONCLUSION: We find evidence of greater probability of virological remission following treatment interruption among African participants, although we are unable to differentiate between sex, ethnicity and viral subtype. The finding warrants further investigation.
AU  - Gossez,M
AU  - Martin,GE
AU  - Pace,M
AU  - Ramjee,G
AU  - Premraj,A
AU  - Kaleebu,P
AU  - Rees,H
AU  - Inshaw,J
AU  - Stöhr,W
AU  - Meyerowitz,J
AU  - Hopkins,E
AU  - Jones,M
AU  - Hurst,J
AU  - Porter,K
AU  - Babiker,A
AU  - Fidler,S
AU  - Frater,J
AU  - SPARTAC,Trial Investigators
DO  - 10.1097/QAD.0000000000002044
EP  - 197
PY  - 2019///
SN  - 0269-9370
SP  - 185
TI  - Virological remission after antiretroviral therapy interruption in female African HIV seroconverters
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0000000000002044
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30325764
UR  - http://hdl.handle.net/10044/1/69487
VL  - 33
ER  -
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