title: The Effect of Therapeutic HIV Vaccination With ALVAC-HIV With or Without Remune on the Size of the Viral Reservoir (A CTN 173 Substudy).
abstract: OBJECTIVE
  To assess whether therapeutic vaccination with ALVAC-HIV ± Remune affects viral reservoir size in antiretroviral therapy-treated individuals.
  
  
  METHODS
  Participants in CTN 173, a multicentre, randomized, 3-arm, placebo-controlled, double-blind study, were vaccinated with ALVAC-HIV ± Remune (groups 1 and 2, respectively) or with placebos (group 3) over 20 weeks and assessed for changes in the size of their viral reservoirs from weeks 0 to 24.
  
  
  RESULTS
  Sixteen participants completed the viral reservoir substudy. The median sizes (interquartile range) of the viral reservoir at baseline (week 0) were 0.07 (0.03-0.37), 0.04 (0.02-0.33), and 0.13 (0.06-0.99) infectious units per million peripheral blood mononuclear cells for groups 1, 2, and 3, respectively; these baseline viral reservoir sizes were not significantly different (P = 0.37). By week 24, the median sizes of the viral reservoirs were 0.04 (0.01-2.16), 0.04 (0.01-0.34), and 0.12 (0.01-0.44) infectious units per million peripheral blood mononuclear cells for groups 1, 2, and 3 respectively; these week 24 viral reservoir sizes were not significantly different (P = 0.91). Furthermore, there were no statistically significant differences between baseline and week 24 reservoir sizes for any of the 3 groups (P = 0.88, P = 1.00, and P = 0.44, respectively).
  
  
  CONCLUSIONS
  Despite evidence that ALVAC-HIV ± Remune was associated with a trend toward a delay in viral rebound and a smaller decrease in CD4 T-cell counts following antiretroviral therapy interruption, ALVAC-HIV ± Remune did not influence the size of the viral reservoir.
authors.affiliation: *Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; †Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ‡Chronic Viral Illnesses Service and Division of Hematology, McGill University Health Centre, Montréal, Quebec, Canada; and §Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Department of Microbiology, Infectious Diseases and Immunology, Montréal, Quebec, Canada.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Angel
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Routy
authors.forename: Gina M
authors.initials: GM
authors.lastname: Graziani
authors.forename: Cécile L
authors.initials: CL
authors.lastname: Tremblay
mesh_terms: D016915:AIDS Vaccines / Q000276:immunology*; D000328:Adult; D018791:CD4 Lymphocyte Count; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000628:therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D016915:AIDS Vaccines; C112734:AIDSVAX; C105086:remune