Structured antiretroviral treatment interruptions in chronically HIV-1-infected subjects.

Published

Journal Article

The risks and benefits of structured treatment interruption (STI) in HIV-1-infected subjects are not fully understood. A pilot study was performed to compare STI with continuous highly active antiretroviral therapy (HAART) in chronic HIV-1-infected subjects with HIV-1 plasma RNA levels (VL) <400 copies per ml and CD4(+) T cells >400 per microl. CD4(+) T cells, VL, HIV-1-specific neutralizing antibodies, and IFN-gamma-producing HIV-1-specific CD8(+) and CD4(+) T cells were measured in all subjects. STIs of 1-month duration separated by 1 month of HAART, before a final 3-month STI, resulted in augmented CD8(+) T cell responses in all eight STI subjects (P = 0.003), maintained while on HAART up to 22 weeks after STI, and augmented neutralization titers to autologous HIV-1 isolate in one of eight subjects. However, significant decline of CD4(+) T cell count from pre-STI level, and VL rebound to pre-HAART baseline, occurred during STI (P = 0.001 and 0.34, respectively). CD4(+) T cell counts were regained on return to HAART. Control subjects (n = 4) maintained VL <400 copies per ml and stable CD4(+) T cell counts, and showed no enhancement of antiviral CD8(+) T cell responses. Despite increases in antiviral immunity, no control of VL was observed. Future studies of STI should proceed with caution.

Full Text

Duke Authors

Cited Authors

  • Ortiz, GM; Wellons, M; Brancato, J; Vo, HT; Zinn, RL; Clarkson, DE; Van Loon, K; Bonhoeffer, S; Miralles, GD; Montefiori, D; Bartlett, JA; Nixon, DF

Published Date

  • November 6, 2001

Published In

Volume / Issue

  • 98 / 23

Start / End Page

  • 13288 - 13293

PubMed ID

  • 11687611

Pubmed Central ID

  • 11687611

International Standard Serial Number (ISSN)

  • 0027-8424

Digital Object Identifier (DOI)

  • 10.1073/pnas.221452198

Language

  • eng

Conference Location

  • United States