Impact of immune interventions on proviral HIV-1 DNA decay in patients receiving highly active antiretroviral therapy.

Abstract:

OBJECTIVE:To measure the evolution of proviral HIV-1 DNA levels in patients receiving highly active antiretroviral therapy (HAART) compared to those treated with HAART plus interleukin-2 (IL-2) and hydroxyurea. DESIGN:Prospective randomised trial. METHODS:Twenty-two HIV-1 infected patients were randomly assigned to a five-drug antiretroviral regimen for 72 weeks, with or without IL-2, followed by a three-drug regimen up to week 120 with additional hydroxyurea in patients having received IL-2. HIV-1 DNA levels in peripheral blood mononuclear cells (PBMC) were measured regularly using the Amplicor Monitor kit from Roche Diagnostics (Meylan, France). Potentially infectious HIV-1 was cultured in enhanced conditions from circulating CD4 T cells at week 120. RESULTS:During the study period of 120 weeks, HIV-1 DNA levels in PBMC decreased by -1.1 log in patients treated with HAART only compared with -1.8 log in patients with additional IL-2 and hydroxyurea. A two-phase decay rate was observed, with an inflexion point at 12 weeks. The second decay was slow, with mean half-lives of 130.1 +/- 21.3 weeks and 95.1 +/- 26.3 weeks for patients on HAART and those receiving additional IL-2 and hydroxyurea, respectively. At week 120, one out of 11 patients with HAART alone compared to six out of 11 in the group with IL-2 and hydroxyurea had undetectable proviral DNA levels and three of them had unsuccessful recovery of replication-competent HIV-1 from blood CD4 T cells. CONCLUSION:Therapeutic strategies combining HAART and immune interventions have higher potency to decrease the number of infected cells than HAART alone.

journal_name

HIV Med

journal_title

HIV medicine

authors

Lafeuillade A,Poggi C,Chadapaud S,Hittinger G,Khiri H,Halfon P

doi

10.1046/j.1468-1293.2001.00065.x

keywords:

subject

Has Abstract

pub_date

2001-07-01 00:00:00

pages

189-94

issue

3

eissn

1464-2662

issn

1468-1293

pii

065

journal_volume

2

pub_type

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