No evidence for decay of the latent reservoir in HIV-1-infected patients receiving intensive enfuvirtide-containing antiretroviral therapy.
Human immunodeficiency virus type 1 (HIV-1) persists in a latent reservoir of infected resting memory CD4 cells in patients receiving antiretroviral therapy. We assessed whether multitarget therapy with enfuvirtide, 2 reverse-transcriptase inhibitors, and a ritonavir-boosted protease inhibitor leads to decay of this reservoir. Nineteen treatment-naive patients initiated this regimen; 9 experienced virologic suppression and continued enfuvirtide-containing therapy for at least 48 weeks. In enfuvirtide-treated patients with virological suppression, there was no decay of the latent reservoir (95% confidence interval for half-life, 11 months to infinity). The stability of the latent reservoir despite intensive therapy suggests that new strategies are needed to eradicate HIV-1 from this reservoir. (ClinicalTrials.gov identifier: NCT00051831 .).
Gandhi
Rajesh T
RT
Massachusetts General Hospital, Boston, Massachusetts 02114, USA. rgandhi@partners.org
Bosch
Ronald J
RJ
Aga
Evgenia
E
Albrecht
Mary
M
Demeter
Lisa M
LM
Dykes
Carrie
C
Bastow
Barbara
B
Para
Michael
M
Lai
Jun
J
Siliciano
Robert F
RF
Siliciano
Janet D
JD
Eron
Joseph J
JJ
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000821:virology*; D004359:Drug Therapy, Combination; D000077560:Enfuvirtide; D005260:Female; D015700:HIV Envelope Protein gp41 / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000627:therapeutic use*; D019562:Viral Load; D017735:Virus Latency / Q000187:drug effects*
D000998:Antiviral Agents; D015700:HIV Envelope Protein gp41; D010446:Peptide Fragments; D000077560:Enfuvirtide