HIV Meds Update: ART in Acute HIV--Decreasing HIV DNA
We know that very early treatment in acute HIV infection decreases HIV RNA; this study shows it also greatly decreases proviral DNA (and reservoir size). Researchers investigated 2 small cohorts of patients in Thailand with acute (and very early) HIV infection, 1 untreated and 1 treated with ART very early; patients were followed for 144 weeks. They found that DNA integration occurs early and rapidly, and that with early and continued ART, total and integrated HIV DNA drops quickly and continues to decrease over time. "ART reduced total HIV DNA levels by 20-fold after 2 weeks and 316-fold after 3 years. Therefore, very early ART offers the opportunity to significantly reduce the frequency of cells harboring HIV." This has implications for cure strategies (which may be more likely to succeed in patients with low HIV reservoirs) and potentially for patients' health irrespective of attempts at cure.
References
- Ananworanich J, Chomont N, Eller LA, et al. HIV DNA Set point is rapidly established in acute HIV infection and dramatically reduced by early ART. EBioMedicine. 2016 Jul 20. pii: S2352-3964(16)30330-9. doi: 10.1016/j.ebiom.2016.07.024. [Epub ahead of print]
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Susa Coffey is medical editor of the NCRC. She is a Professor of Medicine at UCSF in the Division of HIV, Infectious Diseases and Global Medicine and a longtime clinician and educator in HIV at San Francisco General Hospital clinic (“Ward 86”). She also is medical editor of HIV InSite. Dr. Coffey is Co-Lead of the RAPID clinical program at Ward 86, San Francisco General Hospital and the Chair of the RAPID Committee of San Francisco's Getting to Zero campaign.
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Topic(s): Antiretroviral Therapy
