title: Levels of intracellular HIV-DNA in patients with suppressive antiretroviral therapy.
abstract: OBJECTIVE
  The objective of this study is to study factors associated with HIV-DNA levels in chronically infected patients on long-term suppressive antiretroviral therapy (ART).
  
  
  METHODS
  A cross-sectional, multicentre study of patients receiving ART for more than 3 years, HIV-RNA less than 50 copies/ml for more than 2 years and CD4 cell count more than 350 cells/μl.
  
  
  METHODS
  Factors associated with low (<150) or high (>1000), compared with intermediate (150-1000 copies/10 PBMCs) levels of HIV-DNA were investigated using multinomial logistic regression.
  
  
  RESULTS
  Five hundred and twenty-two patients who initiated ART during the chronic phase were included (71% male; median peak HIV-RNA: 4.88 log10 copies/ml, CD4 cell count nadir: 222 cells/μl). Median ART duration was 13 years [interquartile range (IQR) 7-17], viral suppression was 5.7 years (IQR 3.9-8.5) and 66% of the patients never experienced ART failure. Median HIV-DNA was 323 copies/10 PBMCs (IQR, 129-717) with low, intermediate and high levels observed in 28.3, 55.4 and 16.3%, respectively. In multivariable analysis, women were more likely to achieve a low level of HIV-DNA. Each additional year with suppressed HIV-RNA increased the likelihood of low level and decreased the likelihood of high level of HIV-DNA. Peak HIV-RNA higher than 5log10 was always associated with a decreased risk of low and an increased risk of high HIV-DNA. For patients with peak HIV-RNA lower than 5log10, past ART failure was associated with high level of HIV-DNA.
  
  
  CONCLUSIONS
  Chronically HIV-infected patients with long-term suppressive ART can achieve low total HIV-DNA but one over six still presented HIV-DNA above 1000 copies/10 PBMCs despite long-term viral suppression.
authors.affiliation: aRegional Center for HIV Care and Coordination, INSERM UMR1027, Toulouse 3 University, Toulouse bInfectious Diseases Dpt, CHU Archet, Nice cINSERM, U1043, Centre de Physiopathologie de Toulouse Purpan dCHU Toulouse, Hôpital Purpan, Virology Department, National Reference Center for Hepatitis E, Institut fédératif de biologie de Purpan, Toulouse eInfectious Diseases Department, CHU Hotel Dieu, Nantes fAPHP, Department of Therapeutics in Infectious Diseases, Hotel Dieu Hospital gParis Descartes University, EA 7327, Sorbonne Paris Cité, Paris hVirology Department, CHU Nice, Nice iVirology Department, CHU Nantes, Nantes jVirology Department, AP-HP, Hôpital Saint Louis, INSERM U941, Paris Diderot University, Paris kVirology Department, CHU Strasbourg, Strasbourg lSorbonne University, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health mINSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health nAP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris oVirology laboratory, University Hospital of Martinique, Fort-de-France pINSERM, IAME, UMR 1137 qUniv Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité rAP-HP, Hôpital Bichat-Claude Bernard, Virology Department, Paris sVirology Department, CHU Lille, Lille tCHU Clermont Ferrand, Laboratoire de Virologie, Hôpital Gabriel Montpied, Clermont-Ferrand uSorbonne Universities, UPMC Univ. Paris 06, INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France. *Dat'AIDS Study Group members are listed in the Acknowledgements.
authors.forename: Lise
authors.initials: L
authors.lastname: Cuzin
authors.forename: Pascal
authors.initials: P
authors.lastname: Pugliese
authors.forename: Karine
authors.initials: K
authors.lastname: Sauné
authors.forename: Clotilde
authors.initials: C
authors.lastname: Allavena
authors.forename: Jade
authors.initials: J
authors.lastname: Ghosn
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cottalorda
authors.forename: Audrey
authors.initials: A
authors.lastname: Rodallec
authors.forename: Marie Laure
authors.initials: ML
authors.lastname: Chaix
authors.forename: Samira
authors.initials: S
authors.lastname: Fafi-Kremer
authors.forename: Cathia
authors.initials: C
authors.lastname: Soulié
authors.forename: Marlène
authors.initials: M
authors.lastname: Ouka
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.forename: Laurence
authors.initials: L
authors.lastname: Bocket
authors.forename: Audrey
authors.initials: A
authors.lastname: Mirand
authors.forename: Marguerite
authors.initials: M
authors.lastname: Guiguet
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents; D004279:DNA, Viral