title: Structured treatment interruptions (STIs) in HIV-1 infected pediatric populations increases interferon gamma production and reduces viremia.
abstract: We assessed the effect of progressively longer antiretroviral structured treatment interruptions (STIs) starting with 3 days, increasing by 2 days in length each cycle on HIV-specific immune responses. As well, we correlated these responses with control of HIV viremia. Eight individuals became viremic and reached cycle 13 with an STI of > or =27 days. HIV-specific gamma-interferon production to inactivated HIV and vaccinia vectors expressing gag, env, nef, and pol increased (>10-fold) in six of eight subjects. Median plasma RNA levels peaked @ cycle 7 and declined to levels <10(4)cp/ml after cycle 10. In a subset of five who reached cycle 17, HIV-specific IFN-gamma frequencies increased from cycle 8 to cycle 17 with evidence of improved virologic control over comparable periods off antiretroviral therapy. This allowed us to conclude that exposure to autologous virus increased HIV-specific immune responses and decreased HIV RNA were seen in those who have had >13 interruptions, with STI intervals that exceeded 27 days.
authors.affiliation: NYU School of Medicine, New York, NY, USA. borkow01@gcrc.med.nyu.edu
authors.forename: William
authors.initials: W
authors.lastname: Borkowsky
authors.forename: Ram
authors.initials: R
authors.lastname: Yogev
authors.forename: Petronella
authors.initials: P
authors.lastname: Muresan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McFarland
authors.forename: Lisa
authors.initials: L
authors.lastname: Frenkel
authors.forename: Terry
authors.initials: T
authors.lastname: Fenton
authors.forename: Edmond
authors.initials: E
authors.lastname: Capparelli
authors.forename: Jack
authors.initials: J
authors.lastname: Moye
authors.forename: Paul
authors.initials: P
authors.lastname: Harding
authors.forename: Nina
authors.initials: N
authors.lastname: Ellis
authors.forename: Barbara
authors.initials: B
authors.lastname: Heckman
authors.forename: Joyce
authors.initials: J
authors.lastname: Kraimer
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004334:Drug Administration Schedule; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology*; D012367:RNA, Viral / Q000097:blood; D013997:Time Factors; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy* / Q000276:immunology
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D007371:Interferon-gamma