Discontinuation of antiretroviral therapy commenced early during the course of human immunodeficiency virus type 1 infection, with or without adjunctive vaccination.
Sixteen subjects were treated with highly active antiretroviral therapy within 120 days of the onset of symptoms of newly acquired human immunodeficiency virus type 1 (HIV-1) infection. Eleven of the 16 participated in an adjunctive therapeutic vaccine trial. After a mean of 3.2 years of treatment, they elected to discontinue therapy. Virus rebound occurred in all subjects and was followed by a spontaneous, transient although significant reduction in log plasma HIV-1 RNA level, ranging from 0.3 to 3.1 log(10) copies/mL. Despite evidence of the induction of HIV-1-specific cell-mediated immune responses, plasma viremia was not persistently suppressed to <500 copies/mL in any subject. The magnitude and dynamics of virus rebound were similar in both vaccinated and unvaccinated subjects. Nevertheless, given the transient suppression of viremia observed in nearly all subjects after treatment has been discontinued, further investigations of adjunctive vaccination with optimized antiretroviral therapy in treating HIV-1 infection are warranted.
Aaron Diamond AIDS Research Center, Rockefeller University, New York, New York 10016, USA. mmarkowitz@adarc.org
Martin
M
Markowitz
Xia
X
Jin
Arlene
A
Hurley
Viviana
V
Simon
Bharat
B
Ramratnam
Michael
M
Louie
Geoffrey R
GR
Deschenes
Murugappan
M
Ramanathan
Shady
S
Barsoum
Jeroen
J
Vanderhoeven
Tian
T
He
Chris
C
Chung
John
J
Murray
Alan S
AS
Perelson
Linqi
L
Zhang
David D
DD
Ho
D016915:AIDS Vaccines / Q000276:immunology / Q000627:therapeutic use*; D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012367:RNA, Viral / Q000097:blood; D014611:Vaccination
D016915:AIDS Vaccines; D000276:Adjuvants, Immunologic; D012367:RNA, Viral