Dataset Information

The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies.

ABSTRACT:

Background

HIV posttreatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of posttreatment control and posttreatment interruption viral dynamics have not been well characterized.

Methods

Posttreatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ?400 copies/mL at two-thirds or more of time points for ?24 weeks. Viral load and CD4+ cell dynamics were compared between posttreatment controllers and noncontrollers.

Results

Of the 67 posttreatment controllers identified, 38 initiated ART during early HIV infection. Posttreatment controllers were more frequently identified in those treated during early versus chronic infection (13% vs 4%, P < .001). In posttreatment controllers with weekly viral load monitoring, 45% had a peak posttreatment interruption viral load of ?1000 copies/mL and 33% had a peak viral load ?10000 copies/mL. Of posttreatment controllers, 55% maintained HIV control for 2 years, with approximately 20% maintaining control for ?5 years.

Conclusions

Posttreatment control was more commonly identified amongst early treated individuals, frequently characterized by early transient viral rebound and heterogeneous durability of HIV remission. These results may provide mechanistic insights and have implications for the design of trials aimed at achieving HIV remission.

SUBMITTER: Namazi G

PROVIDER: S-EPMC6217727 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies.

Namazi Golnaz G Fajnzylber Jesse M JM Aga Evgenia E Bosch Ronald J RJ Acosta Edward P EP Sharaf Radwa R Hartogensis Wendy W Jacobson Jeffrey M JM Connick Elizabeth E Volberding Paul P Skiest Daniel D Margolis David D Sneller Michael C MC Little Susan J SJ Gianella Sara S Smith Davey M DM Kuritzkes Daniel R DR Gulick Roy M RM Mellors John W JW Mehraj Vikram V Gandhi Rajesh T RT Mitsuyasu Ronald R Schooley Robert T RT Henry Keith K Tebas Pablo P Deeks Steven G SG Chun Tae-Wook TW Collier Ann C AC Routy Jean-Pierre JP Hecht Frederick M FM Walker Bruce D BD Li Jonathan Z JZ

The Journal of infectious diseases 20181101 12

<h4>Background</h4>HIV posttreatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of posttreatment control and posttreatment interruption viral dynamics have not been well characterized.<h4>Methods</h4>Posttreatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ≤400 copies/mL at two-thirds or more of time points for ≥2 ...[more]

PMID: 30085241

Similar Datasets

Project description:BackgroundLess than 1% of Human Immunodeficiency Virus (HIV)-infected individuals are able to achieve spontaneous viral control without requiring antiretroviral therapy (ART). Whether these HIV controllers (HIC) are at risk of HIV-associated comorbidities and could benefit from ART is debated, but recent studies reported decreased T-cell activation upon ART initiation. We report the frequency of ART initiation, reasons to treat, treatment outcome on immunovirological parameters, and rate of side-effects and treatment discontinuation in the French cohort of HIC.MethodsParticipants included in the French multicenter Agence Nationale de Recherche sur le SIDA et les Hépatites (ANRS) Cohorte des extremes (CODEX) cohort of HIC between July 6, 2007 and January 3, 2018 were prospectively followed. ART initiation, indication, discontinuation, non-Acquired ImmunoDeficiency Syndrome (AIDS)-defining events, side-effects, and immunovirological parameters were recorded. Undetectable HIC (u-HIC) were defined as participants with strictly undetectable viral loads based on routinely used assays throughout the follow-up and blipper HIC (b-HIC) as participants with possible detectable viral loads above the detection threshold during follow-up.FindingsAmong 302 HIC followed for a median of 14.8 years [10.3-20.2], 90 (30%) received ART (7 u-HIC and 83 b-HIC). The main reasons for ART initiation were decreased CD4 T-cell counts (n = 36, 40%), loss of virological control (n = 13, 14%), and non-AIDS-defining events (n = 12, 13%). Sixteen (18%) participants experienced 17 grade 1-2 adverse events. In b-HIC, ART slightly increased the CD4/CD8 ratio (median +0.19, p < 0.0001) and decreased the frequency of circulating CD38+ HLA-DR.+ CD4 and CD8 lymphocytes (median -0.75%, p = 0.003, and -2%, p < 0.0001, respectively), but these changes were not observed for treated u-HIC. Thirteen (14%) participants discontinued ART (5 (38%) because of side-effects, and 10 remained HIC after treatment cessation (median follow-up: 305 days [235-728]).InterpretationOnly 30% of participants in this large cohort of HIC required ART during a median follow-up of 14.8 years. These results show that HIC status is very stable and vouch for a patient-centered treatment decision based on the individual benefit/risk balance.

Dataset Information

The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies.

Background

Methods

Results

Conclusions

Publications

The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies.

Similar Datasets

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