title: Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission.
abstract: BACKGROUND
  Therapeutic control of HIV replication reduces the size of the viral reservoir, particularly among central memory CD4+ T cells, and this effect might be accentuated by early treatment.
  
  
  METHODS
  We examined the effect of ART initiated at the time of the primary HIV infection (early ART), lasting 2 and 6 years in 11 and 10 patients, respectively, on the HIV reservoir in peripheral resting CD4+ T cells, sorted into naive (TN), central memory (TCM), transitional memory (TTM) and effector memory (TEM) cells, by comparison with 11 post-treatment controllers (PTCs).
  
  
  RESULTS
  Between baseline and 2 years, CD4+ T cell subset numbers increased markedly (P < 0.004) and HIV DNA levels decreased in all subsets (P < 0.009). TTM cells represented the majority of reservoir cells at both timepoints, T cell activation status normalized and viral diversity remained stable over time. The HIV reservoir was smaller after 6 years of early ART than after 2 years (P < 0.019), and did not differ between PTCs and patients treated for 6 years. One patient, who had low reservoir levels in all T cell subsets after 2 years of treatment similar to the levels in PTCs, spontaneously controlled viral replication during 18 months off treatment.
  
  
  CONCLUSIONS
  Early prolonged ART thus limits the size of the HIV reservoir, protects long-lived cells from persistent infection and may enhance post-treatment control.
authors.affiliation: EA 7327 Paris-Descartes University, Sorbonne Paris-Cité, Virology Laboratory, Necker Enfants-Malades Hospital, Paris, France Infectious Diseases Department, Dron Hospital, Tourcoing, France antoinecheret@free.fr.
authors.forename: Antoine
authors.initials: A
authors.lastname: Chéret
authors.affiliation: Pierre & Marie Curie University Paris VI, INSERM UMR-S 945 Immunity & Infection, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Charline
authors.initials: C
authors.lastname: Bacchus-Souffan
authors.affiliation: EA 7327 Paris-Descartes University, Sorbonne Paris-Cité, Virology Laboratory, Necker Enfants-Malades Hospital, Paris, France Infectious Diseases Department, Dron Hospital, Tourcoing, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Avettand-Fenoël
authors.affiliation: EA 7327 Paris-Descartes University, Sorbonne Paris-Cité, Virology Laboratory, Necker Enfants-Malades Hospital, Paris, France Infectious Diseases Department, Dron Hospital, Tourcoing, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Mélard
authors.affiliation: Epidemiology and Public Health Department, Inserm U1018, AP-HP, Le Kremlin-Bicêtre Hospital, University Paris Sud, Le Kremlin-Bicêtre, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Nembot
authors.affiliation: CyPS Flow Cytometry Platform, Pierre & Marie Curie University, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Blanc
authors.affiliation: Pierre & Marie Curie University Paris VI, INSERM UMR-S 945 Immunity & Infection, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Assia
authors.initials: A
authors.lastname: Samri
authors.affiliation: Pasteur Institute, Regulation of Retroviral Infections Unit, Paris, France.
authors.forename: Asier
authors.initials: A
authors.lastname: Sáez-Cirión
authors.affiliation: Infectious Diseases Department, Hospital de la Source, Orléans, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Hocqueloux
authors.affiliation: Infectious Diseases Department, AP-HP, Saint-Louis Hospital, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.affiliation: Infectious Diseases Department, Hôtel-Dieu Hospital, Nantes, France.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Allavena
authors.affiliation: Internal Medicine Department, AP-HP, Le Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.affiliation: Infectious Diseases Department, AP-HP, Pitié-Salpêtrière Hospital, University Paris XII, Paris, France.
authors.forename: Marc Antoine
authors.initials: MA
authors.lastname: Valantin
authors.affiliation: Infectious Diseases Department, l'Archet Hospital, Nice, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Leplatois
authors.affiliation: Epidemiology and Public Health Department, Inserm U1018, AP-HP, Le Kremlin-Bicêtre Hospital, University Paris Sud, Le Kremlin-Bicêtre, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Meyer
authors.affiliation: EA 7327 Paris-Descartes University, Sorbonne Paris-Cité, Virology Laboratory, Necker Enfants-Malades Hospital, Paris, France Infectious Diseases Department, Dron Hospital, Tourcoing, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.affiliation: Pierre & Marie Curie University Paris VI, INSERM UMR-S 945 Immunity & Infection, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Autran
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV DNA; post-treatment controllers; primary HIV infections; reservoirs