icon-folder.gif   Conference Reports for NATAP  
  53rd ICAAC Interscience Conference on
Antimicrobial Agents and Chemotherapy
September 10-13, 2013, Denver CO
Back grey_arrow_rt.gif
Cellular HIV DNA Predicts Plasma Load Under 2.5 Copies in 181-Person Study
  53rd ICAAC, September 10-13, 2013, Denver
Mark Mascolini
Lower HIV DNA in peripheral blood mononuclear cells (PBMCs) strongly predicted having a plasma viral load below 2.5 copies/mL in a longitudinal study involving 181 virologic responders [1]. People who began antiretroviral therapy during primary infection reached the lowest HIV DNA levels in the study and had the best chance of reaching a plasma load below 2.5 copies.
HIV DNA in PBMCs offers an approximation of the cellular viral reservoir. Because the clinical and prognostic significance of low HIV DNA remains uncertain, researchers from Padova University and other centers undertook this longitudinal study of identify links between HIV DNA in PBMCs and a viral load below 2.5 copies/mL in plasma.
The analysis involved 181 antiretroviral-naive people reaching a viral load below 50 copies within 6 months of starting their first regimen and always maintaining a sub-50 load. The investigators measured their CD4 counts, HIV DNA in PBMCs, and HIV RNA in plasma before treatment began (T0) and at three follow-up points: T1 at a median of 24 months, T2 at a median of 36 months, and T3 at a median of 48 months. Seventy of 181 people (39%) had T3 results. The DNA assay had a sensitivity below 5 copies/million cells and the RNA assay detected levels down to 2.5 copies/mL.
Of the 181 study participants, 139 (77%) were men and 56 (31%) men who have sex with men. Twenty-three people (13%) joined the cohort with acute infection. Pretreatment CD4 count averaged 259, CD4 percent 15.6%, HIV DNA 2942 copies/million cells, and plasma viral load 219,506 copies.
From the T0 average level of 2942 copies/million PBMCs, HIV DNA fell to 256 copies at T1, then more slowly to 141 copies at T2, and 108 copies at T3. HIV DNA at all four times strongly predicted having a plasma load below 2.5 copies at the subsequent time (all P values between 0.048 and 0.0023). However, the researchers did not provide r values or explain the methods they used to define these associations.
Primary HIV infection when antiretroviral therapy began was associated with the lowest HIV DNA levels at all points, with a higher likelihood of reaching a plasma load below 2.5 copies, and with better immune recovery. But the researchers did not detail the data for these associations.
1. Parisi SG, Samantha A, Scaggiante R, et al. Strong correlation between the reduction of cellular HIV-DNA load and achievement of HIV plasma viremia <2.5 copies/mL in an observation period of 4 years of effective antiretroviral therapy in naive patients. 53rd ICAAC. September 10-13, 2013. Denver. Abstract H-673.