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The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies.

Authors :
Namazi, Golnaz
Fajnzylber, Jesse M
Aga, Evgenia
Bosch, Ronald J
Acosta, Edward P
Sharaf, Radwa
Hartogensis, Wendy
Jacobson, Jeffrey M
Connick, Elizabeth
Volberding, Paul
Skiest, Daniel
Margolis, David
Sneller, Michael C
Little, Susan J
Gianella, Sara
Smith, Davey M
Kuritzkes, Daniel R
Gulick, Roy M
Mellors, John W
Mehraj, Vikram
Source :
Journal of Infectious Diseases; 12/15/2018, Vol. 218 Issue 12, p1954-1963, 10p
Publication Year :
2018

Abstract

<bold>Background: </bold>HIV posttreatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of posttreatment control and posttreatment interruption viral dynamics have not been well characterized.<bold>Methods: </bold>Posttreatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ≤400 copies/mL at two-thirds or more of time points for ≥24 weeks. Viral load and CD4+ cell dynamics were compared between posttreatment controllers and noncontrollers.<bold>Results: </bold>Of the 67 posttreatment controllers identified, 38 initiated ART during early HIV infection. Posttreatment controllers were more frequently identified in those treated during early versus chronic infection (13% vs 4%, P < .001). In posttreatment controllers with weekly viral load monitoring, 45% had a peak posttreatment interruption viral load of ≥1000 copies/mL and 33% had a peak viral load ≥10000 copies/mL. Of posttreatment controllers, 55% maintained HIV control for 2 years, with approximately 20% maintaining control for ≥5 years.<bold>Conclusions: </bold>Posttreatment control was more commonly identified amongst early treated individuals, frequently characterized by early transient viral rebound and heterogeneous durability of HIV remission. These results may provide mechanistic insights and have implications for the design of trials aimed at achieving HIV remission. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00221899
Volume :
218
Issue :
12
Database :
Complementary Index
Journal :
Journal of Infectious Diseases
Publication Type :
Academic Journal
Accession number :
132868756
Full Text :
https://doi.org/10.1093/infdis/jiy479