| Publication Abstract Display | | Type: Published Manuscript | | Title: The Control of HIV after Antiretroviral Medication Pause (CHAMP) Study: Post-treatment controllers identified from 14 clinical studies. | | Authors: Namazi G, Fajnzylber JM, Aga E, Bosch R, Acosta EP, Sharaf R, Hartogensis W, Jacobson JM, Connick E, Volberding P, Skiest D, Margolis D, Sneller MC, Little SJ, Gianella S, Smith D, Kuritzkes DR, Gulick RM, Mellors JW, Mehraj V, Gandhi RT, Mitsuyasu R, Schooley RT, Henry K, Tebas P, Deeks S, Chun T, Collier AC, Routy J, Hecht FM, Walker BD, Li JZ | | Year: 2018 | | Publication: The Journal of Infectious Diseases | | Volume: 218 Issue: 12 Pages: 1954-1963 | | Abstract:Background:
HIV post-treatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of post-treatment control and post-treatment interruption viral dynamics have not been well-characterized.
Methods:
Post-treatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ≤400 copies/mL at ≥2/3 of time points for ≥24 weeks. Viral load and CD4+ cell dynamics were compared between post-treatment controllers and non-controllers.
Results:
Of the 67 post-treatment controllers identified, 38 initiated ART during early HIV infection. Post-treatment controllers were more frequently identified in those treated during early vs. chronic infection (13% vs. 4%, P<0.001). In post-treatment controllers with weekly viral load monitoring, 45% had a peak post-treatment interruption viral load of ≥1,000 copies/mL and 33% had a peak viral load ≥10,000 copies/mL. 55% of post-treatment controllers maintained HIV control for 2 years, with approximately 20% maintaining control for ≥5 years.
Conclusions:
Post-treatment 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 has implications for the design of trials aimed at achieving HIV remission. |
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