 |
|
|
| |
Low HIV+ Cell Tally in Blood, Colon, Lymph Nodes in Earliest Infection Phase
|
| |
| |
9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
Mark Mascolini
During the earliest stage of HIV infection, Fiebig I, levels of HIV-infected cells in blood, colon, and lymph nodes are significantly lower than at any other acute infection phase (Fiebig II to V), according to an analysis of 235 people in Thailand [1]. Up to 2 years after Fiebig I patients start antiretroviral therapy (ART), they usually reach undetectable levels of integrated HIV DNA in blood and tissues, while Fiebig II to V patients usually have detectable integrated HIV DNA levels still below those of people who start ART in chronic HIV infection.
Prior work shows that starting ART during primary HIV infection limits the size of the HIV reservoir in blood. Researchers in Canada, the United States, and Thailand conducted a new study to chart levels of HIV-infected cells at various stages of acute infection before and after therapy begins. The investigators recruited acutely infected participants from the Thai Red Cross Anonymous Clinic in Bangkok and determined their Fiebig stage. They used PCR to measure integrated HIV DNA in peripheral blood mononuclear cells (PBMCs), in lymph node mononuclear cells (LNMCs), and in gut biopsy tissue.
The first analysis focused on 235 untreated people, including 31 with LNMC analysis, 70 with gut biopsies, and 134 with PBMC analysis. Respective numbers in each of those three groups at Fiebig I were 6, 6, and 12. There were 335 people who received ART for 24, 48, or 96 weeks, including 30 with LNMC analysis, 56 with gut biopsies, and 249 with PBMC analysis. Respective numbers at Fiebig I were 6, 8, and 33.
Fiebig I patients had lower frequencies of integrated HIV DNA in blood, colon, and lymph nodes than patients in any other group. Even frequency differences between Fiebig I and Fiebig II were statistically significant. Fiebig II to V patients had HIV DNA frequencies in lymph nodes and colon similar to those of people with chronic HIV infection. But Fiebig II to V individuals had lower integrated HIV DNA levels in blood than chronically infected people.
Six months to 2 years after ART began, almost all Fiebig I patients had undetectable levels of integrated HIV DNA in blood, lymph nodes, and colon. Integrated HIV DNA could be detected at all three sites in most treated people at Fiebig II to V. But treated Fiebig II to V patients had lower HIV DNA levels at all three sites than people who started ART in chronic infection.
The researchers also found that at baseline and during ART levels of integrated HIV DNA in blood reflect levels in lymph nodes and colon (r values comparing HIV DNA in lymph nodes versus PBMCs and colon versus PBMCs ranged from 0.4 to 0.7, all P
In all compartments analyzed, the researcher concluded, Fiebig I patients had lower frequencies of HIV-infected cells than any other group acutely or chronically infected with HIV. Yet "with ART, levels of integrated HIV DNA decrease in all acutely treated individuals in blood and tissues whereas chronically treated individuals maintain similar levels of infected cells before and after ART in all compartments."
Reference
1. Leyre L, Ananworanich J, Vandergeeten C, et al. Low frequencies of HIV-infected cells in blood, colon and lymph node at the earliest stage of acute infection (Fiebig I). 9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris. Abstract MOPEA0081.
|
| |
|
|
|
|
|
