TY - JOUR
T1 - Factors influencing virologic control during analytical treatment interruptions in HIV cure trials - a pooled analysis of individual level data
AU - Klastrup, Vibeke
AU - Gunst, Jesper Damsgaard
AU - Rasmussen, Thomas Aagaard
AU - Tolstrup, Martin
AU - Søgaard, Ole Schmeltz
PY - 2025/7/15
Y1 - 2025/7/15
N2 - Background. Achieving antiretroviral therapy (ART)-free virologic control remains a central goal in human immunodeficiency virus (HIV) cure research. To identify factors associated with time to detectable viremia and time to loss of virologic control, we conducted a pooled analysis of 6 interventional trials that included analytical ART interruption. Methods. We determined factors influencing time to detectable viremia (plasma HIV-RNA ≥50 copies/mL) and loss of virologic control (2 consecutive measurements of plasma HIV-RNA ≥5000 copies/mL or restart of ART) using Cox proportional hazard regression. Results. Among the 91 included participants we found that high levels of total HIV-DNA (≥750 copies/mL) and intact proviral DNA (≥80 copies/106 CD4+ T cells) were both associated with shorter time to detectable viremia (hazard ratio [HR] = 1.98; 95% confidence interval [CI], 1.22-3.22 and HR = 1.67; 95% CI, 1.08-2.58, respectively). Total HIV-DNA ≥750 copies/106 CD4+ T cells also predicted shorter time to loss of virologic control (HR = 1.64; 95% CI, 1.01-2.67), as did longer time (≥1 year) from HIV diagnosis to ART start (HR = 1.56; 95% CI, 1.02-2.39). Having received histone deacetylase inhibitors predicted shorter time to loss of virologic control (HR = 2.22; 95% CI, 1.12-4.41), while broadly neutralizing anti-HIV-1 antibody treatment at ART initiation of individuals harboring 3BNC117-sensitive viruses trended towards delayed time to loss of virologic control (HR = 0.32; 95% CI,. 10-1.01). Conclusions. Our findings highlight the positive impact of early ART and low HIV reservoirs on time to rebound among people undergoing analytical treatment interruption and provides new insight into therapeutic interventions aimed at achieving virologic control.
AB - Background. Achieving antiretroviral therapy (ART)-free virologic control remains a central goal in human immunodeficiency virus (HIV) cure research. To identify factors associated with time to detectable viremia and time to loss of virologic control, we conducted a pooled analysis of 6 interventional trials that included analytical ART interruption. Methods. We determined factors influencing time to detectable viremia (plasma HIV-RNA ≥50 copies/mL) and loss of virologic control (2 consecutive measurements of plasma HIV-RNA ≥5000 copies/mL or restart of ART) using Cox proportional hazard regression. Results. Among the 91 included participants we found that high levels of total HIV-DNA (≥750 copies/mL) and intact proviral DNA (≥80 copies/106 CD4+ T cells) were both associated with shorter time to detectable viremia (hazard ratio [HR] = 1.98; 95% confidence interval [CI], 1.22-3.22 and HR = 1.67; 95% CI, 1.08-2.58, respectively). Total HIV-DNA ≥750 copies/106 CD4+ T cells also predicted shorter time to loss of virologic control (HR = 1.64; 95% CI, 1.01-2.67), as did longer time (≥1 year) from HIV diagnosis to ART start (HR = 1.56; 95% CI, 1.02-2.39). Having received histone deacetylase inhibitors predicted shorter time to loss of virologic control (HR = 2.22; 95% CI, 1.12-4.41), while broadly neutralizing anti-HIV-1 antibody treatment at ART initiation of individuals harboring 3BNC117-sensitive viruses trended towards delayed time to loss of virologic control (HR = 0.32; 95% CI,. 10-1.01). Conclusions. Our findings highlight the positive impact of early ART and low HIV reservoirs on time to rebound among people undergoing analytical treatment interruption and provides new insight into therapeutic interventions aimed at achieving virologic control.
KW - HIV
KW - cure
KW - interventions
KW - latency
KW - reservoir
UR - https://www.scopus.com/pages/publications/105012384657
U2 - 10.1093/infdis/jiaf163
DO - 10.1093/infdis/jiaf163
M3 - Journal article
C2 - 40139936
SN - 0022-1899
VL - 232
SP - 69
EP - 78
JO - The Journal of Infectious Diseases
JF - The Journal of Infectious Diseases
IS - 1
ER -