Decay characteristics of HIV-1-infected compartments during combination therapy.

Abstract:

:Analysis of changes in viral load after initiation of treatment with potent antiretroviral agents has provided substantial insight into the dynamics of human immunodeficiency virus type 1 (HIV-1). The concentration of HIV-1 in plasma drops by approximately 99% in the first two weeks of treatment owing to the rapid elimination of free virus with a half-life (t1/2) of < or =6 hours and loss of productively infected cells with a t1/2 of 1.6 days. Here we show that with combination therapy this initial decrease is followed by a slower second-phase decay of plasma viraemia. Detailed mathematical analysis shows that the loss of long-lived infected cells (t1/2 of 1-4 weeks) is a major contributor to the second phase, whereas the activation of latently infected lymphocytes (t1/2 of 0.5-2 weeks) is only a minor source. Based on these decay characteristics, we estimate that 2.3-3.1 years of a completely inhibitory treatment would be required to eliminate HIV-1 from these compartments. To eradicate HIV-1 completely, even longer treatment may be needed because of the possible existence of undetected viral compartments or sanctuary sites.

journal_name

Nature

journal_title

Nature

authors

Perelson AS,Essunger P,Cao Y,Vesanen M,Hurley A,Saksela K,Markowitz M,Ho DD

doi

10.1038/387188a0

subject

Has Abstract

pub_date

1997-05-08 00:00:00

pages

188-91

issue

6629

eissn

0028-0836

issn

1476-4687

journal_volume

387

pub_type

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