title: Factors associated with a low HIV reservoir in patients with prolonged suppressive antiretroviral therapy.
abstract: OBJECTIVE
  The relevance of low-level HIV DNA in patients who have undergone prolonged therapy is not well understood. The objective of this study was to determine factors that influence the establishment of low-level HIV DNA in long-term treated patients (excluding treatment since acute infection).
  
  
  METHODS
  This was a cross-sectional study involving 243 patients receiving highly active antiretroviral therapy (HAART) for ≥6 months (median: 9 years of treatment) with plasma HIV RNA <50 copies/mL at the study timepoint, for whom total DNA measurements were performed. Patients treated since early acute infection or receiving cancer chemotherapeutic/immunosuppressive agents were excluded from the study.
  
  
  RESULTS
  Overall, the median HIV DNA was 372 copies/10(6) peripheral blood mononuclear cells (PBMCs). Forty-seven patients had levels of HIV DNA below the limit of detection and 58 patients had low-level HIV DNA (<100 copies/10(6) PBMCs). In multivariate analysis, a low total HIV DNA in HAART-treated patients was clearly associated with a low HIV RNA pre-therapeutic viral load (P < 0.0001), regardless of the cut-off used.
  
  
  CONCLUSIONS
  These results may be helpful to identify candidates for future trials aiming at a functional cure of HIV infection, since low total HIV DNA levels will most likely be a prerequisite of successful immunological control of HIV replication.
authors.affiliation: Inserm UMR S-943, Paris, France.
authors.forename: Slim
authors.initials: S
authors.lastname: Fourati
authors.forename: Philippe
authors.initials: P
authors.lastname: Flandre
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Calin
authors.forename: Guislaine
authors.initials: G
authors.lastname: Carcelain
authors.forename: Cathia
authors.initials: C
authors.lastname: Soulie
authors.forename: Sidonie
authors.initials: S
authors.lastname: Lambert-Niclot
authors.forename: Almoustapha
authors.initials: A
authors.lastname: Maiga
authors.forename: Zaina
authors.initials: Z
authors.lastname: Ait-Arkoub
authors.forename: Roland
authors.initials: R
authors.lastname: Tubiana
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Valantin
authors.forename: Brigitte
authors.initials: B
authors.lastname: Autran
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Vincent
authors.initials: V
authors.lastname: Calvez
authors.forename: Anne-Genevieve
authors.initials: AG
authors.lastname: Marcelin
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006678:HIV / Q000235:genetics / Q000302:isolation & purification*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology; D008297:Male; D008875:Middle Aged; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification*; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral
keywords: ART; HIV immunity; antiretroviral therapy