title: HIV-1 control after transient antiretroviral treatment initiated in primary infection: role of patient characteristics and effect of therapy.
abstract: BACKGROUND
  The occurrence of viral control after interruption of an antiretroviral treatment (ART) initiated during primary HIV-1 infection (PHI) is rare and the frequency and predictive factors of such a control are unknown.
  
  
  METHODS
  Within the French ANRS PRIMO Cohort, 164 patients interrupted ART initiated during PHI. We compared patients whose viral load (VL) remained undetectable (<50 copies/ml) or low (50-500 copies/ml) 1 year after ART interruption to those who evidenced a rapid viral rebound.
  
  
  RESULTS
  After ART interruption, VL remained undetectable for a median time of 4.5 years in 14 patients ('post-ART controllers') and low in another 14 patients for a median time of 1.5 years. Post-ART controllers also maintained higher CD4(+) T-cell counts compared to other patients. Female gender, a high CD4(+) T-cell count and low VL during PHI, and a high CD4(+) T-cell count and low HIV DNA levels at interruption, were associated with post-ART HIV control. Treatment characteristics did not differ between controllers and non-controllers. Post-ART controllers had lower specific CD8(+) T-cell frequencies and CD8(+) T-cell activation on ART and after ART interruption than non-controllers.
  
  
  CONCLUSIONS
  Few patients maintain very low VL after interruption of treatment initiated during PHI. Early patient characteristics were the main factors of viral control, although early initiation of ART and the effect of ART on reservoir might contribute to control.
authors.affiliation: Service de Médecine Interne, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre, France. cecile.goujard@bct.aphp.fr
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.forename: Isabelle
authors.initials: I
authors.lastname: Girault
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.forename: Camille
authors.initials: C
authors.lastname: Lécuroux
authors.forename: Christiane
authors.initials: C
authors.lastname: Deveau
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Chaix
authors.forename: Christine
authors.initials: C
authors.lastname: Jacomet
authors.forename: Amel
authors.initials: A
authors.lastname: Talamali
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Delfraissy
authors.forename: Alain
authors.initials: A
authors.lastname: Venet
authors.forename: Laurence
authors.initials: L
authors.lastname: Meyer
authors.forename: Martine
authors.initials: M
authors.lastname: Sinet
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D004334:Drug Administration Schedule; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology / Q000472:pathogenicity*; D006801:Humans; D007111:Immunity, Cellular; D053208:Kaplan-Meier Estimate; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000821:virology; D008213:Lymphocyte Activation; D008297:Male; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects; D014766:Viremia / Q000188:drug therapy / Q000276:immunology; D014779:Virus Replication
chemical_list: D019380:Anti-HIV Agents; D015483:HIV Antibodies; D012367:RNA, Viral