Distinct mechanisms of long-term virologic control in two HIV-infected individuals after treatment interruption of anti-retroviral therapy.

Journal Article (Journal Article)

Certain infected individuals suppress human immunodeficiency virus (HIV) in the absence of anti-retroviral therapy (ART). Elucidating the underlying mechanism(s) is of high interest. Here we present two contrasting case reports of HIV-infected individuals who controlled plasma viremia for extended periods after undergoing analytical treatment interruption (ATI). In Participant 04, who experienced viral blips and initiated undisclosed self-administration of suboptimal ART detected shortly before day 1,250, phylogenetic analyses of plasma HIV env sequences suggested continuous viral evolution and/or reactivation of pre-existing viral reservoirs over time. Antiviral CD8+ T cell activities were higher in Participant 04 than in Participant 30. In contrast, Participant 30 exhibited potent plasma-IgG-mediated neutralization activity against autologous virus that became ineffective when he experienced sudden plasma viral rebound 1,434 d after ATI due to HIV superinfection. Our data provide insight into distinct mechanisms of post-treatment interruption control and highlight the importance of frequent monitoring of undisclosed use of ART and superinfection during the ATI phase.

Full Text

Duke Authors

Cited Authors

  • Blazkova, J; Gao, F; Marichannegowda, MH; Justement, JS; Shi, V; Whitehead, EJ; Schneck, RF; Huiting, ED; Gittens, K; Cottrell, M; Benko, E; Kovacs, C; Lack, J; Sneller, MC; Moir, S; Fauci, AS; Chun, T-W

Published Date

  • November 2021

Published In

Volume / Issue

  • 27 / 11

Start / End Page

  • 1893 - 1898

PubMed ID

  • 34711975

Electronic International Standard Serial Number (EISSN)

  • 1546-170X

Digital Object Identifier (DOI)

  • 10.1038/s41591-021-01503-6


  • eng

Conference Location

  • United States