title: Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy.
abstract: OBJECTIVE
  A minority of HIV-1 positive individuals treated with antiretroviral therapy (ART) in primary HIV-1 infection (PHI) maintain viral suppression on stopping. Whether this is related to ART duration has not been explored.
  
  
  METHODS
  And Methods: Using SPARTAC trial data from individuals recruited within 6 months of seroconversion, we present an observational analysis investigating whether duration of ART was associated with post-treatment viraemic control. Kaplan-Meier estimates, logistic regression and Cox models were used.
  
  
  RESULTS
  165 participants reached plasma viral loads (VL) <400 copies/ml at the time of stopping therapy (ART stop). After ART stop, 159 experienced confirmed VL ≥400 copies/ml during median (IQR) follow-up of 167 (108,199) weeks. Most participants experienced VL rebound within 12 weeks from ART stop, however, there was a suggestion of a higher probability of remaining <400 copies/ml for those on ART >12 weeks compared to ≤12 weeks (p=0.061). Cumulative probabilities of remaining <400 copies/ml at 12, 52 and 104 weeks after ART stop were 21% (95%CI=13,30), 4% (1,9), and 4% (1,9) for ≤12 weeks ART, and 32% (22,42), 14% (7,22), and 5% (2,11) for >12 weeks. In multivariable regression, ART for >12 weeks was independently associated with a lower probability of being ≥400 copies/ml within 12 weeks of ART stop (OR=0.11 (95%CI=0.03,0.34), p<0.001)). In Cox models of time to VL ≥400 after 12 weeks, we only found an association with female sex (OR=0.2, p=0.001).
  
  
  CONCLUSIONS
  Longer ART duration in PHI was associated with a higher probability of viral control after ART stop.
  
  
  BACKGROUND
  Controlled-Trials.com 76742797 http://www.controlled-trials.com/ISRCTN76742797.
authors.affiliation: Medical Research Council Clinical Trials Unit, London, United Kingdom.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stöhr
authors.forename: Sarah
authors.initials: S
authors.lastname: Fidler
authors.forename: Myra
authors.initials: M
authors.lastname: McClure
authors.forename: Jonathan
authors.initials: J
authors.lastname: Weber
authors.forename: David
authors.initials: D
authors.lastname: Cooper
authors.forename: Gita
authors.initials: G
authors.lastname: Ramjee
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tambussi
authors.forename: Mauro
authors.initials: M
authors.lastname: Schechter
authors.forename: Abdel
authors.initials: A
authors.lastname: Babiker
authors.forename: Rodney E
authors.initials: RE
authors.lastname: Phillips
authors.forename: Kholoud
authors.initials: K
authors.lastname: Porter
authors.forename: John
authors.initials: J
authors.lastname: Frater
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000235:genetics; D019562:Viral Load / Q000187:drug effects / Q000235:genetics; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral